Paying for Prescription Drugs | National Pharmacare Online Consultation | Let's Talk Health

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Paying for Prescription Drugs

about 1 month ago

Canadians who are currently covered by a drug insurance plan contribute to the costs of their prescription drugs in a number of ways. Common methods include through making ‘co-payments’ (e.g., paying for a certain percentage of the cost of their prescription at the pharmacy) or through paying deductibles or annual fees (e.g., premiums) toward their drug coverage plan.

What are benefits and drawbacks of individuals paying a portion of the cost of their prescription drugs? Share your thoughts below:

Thank you for your interest in this consultation with the Advisory Council on the Implementation of National Pharmacare.

The online consultation is now closed, and written submissions are no longer being accepted. You can still keep in touch with us via email at pharmacare-assurancemedicaments@canada.ca.

Please stay tuned for the consultation report, which will be posted here and on the following website: www.canada.ca/pharmacare.

Sincerely,

Advisory Council on the Implementation of National Pharmacare

***************************************************************************

  • AnonKingston 17 days ago
    The cost of paying a part far outweigh the benefits of universal coverage without cost to the individual. The only benefit I see is reduce cost to the government budget. One could argue that this provides information to the individual about the cost of receiving the drugs needed. One could also argue that there is a disincentive to overuse medications. However, the former can be accomplished by sending monthly accounts to the individual so they can see what the costs were without them being out of pocket. The disincentive is going to undermine the whole purpose of universal pharmacare. To allow all people access as needed without a bureaucratic burden. There is an additional danger. There will always be an excuse for government to increase the charges, for example to cut taxes or to pay for other interests. The long term consequences will be an added burden to the health care system and a shorter life span for those who avoid taking necessary medication.
  • Kible 17 days ago
    The benefits of having individuals pay a portion of the cost would be that there would be less pressure on the system to cover the cost of drugs. The drawbacks of having a system where individuals pay for a portion of their cost is that, the poor and vulnerable in society will have to pay for a portion of their costs. Unfortunately if an individual is elderly, they would have to possibly ask family members for financial assistance or make sacrifices to pay their medications.This could be made worse if the individual is on multiple medications that are expensive, it could be made worse by an individual that has family members who have illnesses as well and that have to pay for a portion of their drug costs as well. This could put financial pressure on an individuals budget and lead to increased poverty.
  • Peeboo1954 17 days ago
    I pay $110 a month for a drug plan
  • pharmacaremama 17 days ago
    Any solution that involves co-pays or premiums absolutely has to involve simple, easy to access relief to those who can't afford it. Poverty and conditions that require prescription medications co-exist very often, for interrelatedly causal reasons. The burden of co-pays could be very high indeed in a family with many health conditions and low income. The burdens on the working poor must be well-understood, and the solutions cannot be onerous for them. Annual fees are perhaps more equitable, but there should be automatic and easily appealable cutoffs (e.g. through federal income tax systems) rather than whole separate application processes for relief. We have to keep things very, very simple for people to access.
  • Paul Blanchard 17 days ago
    The concept behind a copayment policy is to ensure the patient has an idea of what the drugs and services cost. There is no point in having a flat copay. It should always be a %. For example, most Canadians have no idea that the average generic prescription costs $20.70. If you're paying a$5 copay that's almost 25%. About 3 of every 4 prescriptions are generic. A lot of people don't like the generic and tell their doctor they have an allergy or intolerance. The brand costs a lot more. If you're paying a flat copay fee, you don't care if you get the cheaper of expensive drug. I think a better policy is to have a low copay or even zero copay on generic products and a 'regular' copay on the brand to an annual cap, based on patient's ability to pay. This would affect people's behaviour. There is a lot of waste in the system now.
  • MKC 17 days ago
    Premiums, co-payments, deductibles, etc. for health care services are simply hidden taxes on the poor. They have shown over and over again to have no health care benefits. They are outrageous. We have a graduated income tax system and we should use that to fund the system.
  • sm-1994 17 days ago
    Pros: May cut back on over prescribing & taking medication longer than clinically necessary.Cons: Patients may not fill vital prescriptions due to cost.It is vital that we look at Net income when deciding on deductible and co-pays.
  • Piccolino 17 days ago
    Nearly 2 million Canadians cannot afford their prescription medications, including many individuals who have private insurance for prescription drugs. Every Canadian should have access to prescription medications they require based on need, not ability to pay.
  • Nancyjo23 18 days ago
    It’s not fair to seniors who will have to choose between drugs and food which will result in more costs to the health care system
  • Pilon 18 days ago
    Paying a portion of drug care may encourage individuals to not over use prescription drugs HOWEVER, I believe when people can’t afford their prescriptions they done buy them therefore don’t take essential medications, become further ill and end up in hospital which is far more expensive on the system and possible life threatening to the individual
  • SMA 18 days ago
    I HAVE NO ISSUES WITH THOSE WHO CAN AFFORD TO PAY A PORTION OFF THEIR PHARMACEUTICAL COSTS IF THEY CAN AFFORD TO. UNFORTUNATELY THE MAJORITY OF PATIENTS WITH THE HIGHEST DRUG COSTS ARE UNABLE TO WORK, UNABLE TO GET INSURANCE AND UNABLE TO AFFORD TO PAY EVEN A SMALL PORTION OF THEIR DRUG COSTS. IN SUCH SITUATIONS PATIENTS ARE LEFT WITH THE DECISION OF WHAT BILLS THEY SHOULD PAY. SHOULD I PAY THE RENT OR THE OVERDUE HYDRO BILL. IN THE END MOST DECIDE TO KEEP A ROOF OVER THEIR HEAD AND GO WITHOUT THEIR MEDICATIONS. THE ONLY WAY CANADIANS CAN AVOID BEING PUT IN SUCH A SITUATION IS A NATIONAL PHARMACARE PROGRAM WITH NO DEDUCTIBLE'S OR CO-PAYMENTS.
  • billlamond 19 days ago
    Persons who have to pay a portion of their drug costs may be reluctant to renew a Rx if it is a very expensive medication and they have to pay a fairly large percentage of the drug cost. On the otherhand this system lets people know how expensive their drugs are so there is less waste.
  • Damn technology 19 days ago
    Partial payment is not bad but not everyone has insurance plan and we are paying too much for our prescriptions anyway. If the government can get costs down, it should act immediately.
  • NickelCity 19 days ago
    Methods of payment are not equivalent for each of the socio-economic classes that comprise Canadian society. If premiums are necessary, there should only be one premium rate that should be low in cost and payable through income tax
  • AndrewHelenPlouffe 19 days ago
    This wastes time , increases book keeping
  • motherofdragons 19 days ago
    I’ve paid both deductible as well as percentages of prescriptions and in most cases either one was great. I agree with paying different percentages or deductible amounts based on family income.
  • Writerannie 19 days ago
    I have had serious healrh issues my whole life that cost a fortune in drugs to control. I was lucky enough to work for a company that paid a large part of my supplemental health care. Wirhout that I would not have been able to afford my meds and would now be dead. I know a lot of oeopke out here in BC..self employed etc or working for companies wirh no extra coverage who still cannot afford their meds...you think this only happens in the States..think again..Some of my drugs cost a fortune...its preposterous...Big Pharma lives well..many senior Canadians just sir and worry.
  • health53 19 days ago
    I don't think a co-pay system is a bad idea, but it should be geared to income. $5 to a person with a $15,000 income is not the same as it is for someone earning $65,000.
  • LynMarie25 19 days ago
    All drugs necessary for good health and prescribed by a doctor or other health care provider should be covered. Low income families and most seniors should be fully covered. Higher income earners and even seniors with an income above a certain level should pay a portion of the costs of their prescriptions. Expensive drugs for rare conditions should be covered.
  • donbuck 19 days ago
    The benefits of having a drug insurance plan, is the person pays a low percentage of 50% on each drug no matter the cost of drug. And the drawbacks are there will be no lower percentage cost for the drug to save person more money. But any persons who does not have any kind drug insurance plan, end up paying the total cost. This mostly effects seniors, and persons on very low income who can not afford to pay for the drugs they need at all. These are the ones that have to get their prescriptions paid up fully by the Government, so they will never go without getting their prescriptions again.
  • Aine 20 days ago
    I believe that all drugs should be free or at a minimal cost to all seniors. Part of the problem with the high cost of prescription drugs is that there are to many doctors prescribing a lot of unnecessary medication's .In some cases trying to push to you take Meds instead of other alternatives.
  • tyghbn 20 days ago
    There a pluses and minuses to user pay situations no matter which way you look at it. User pay should play a role though. Even if it has a basis in ability to pay it needs to be there. Those that don't have the ability to pay can move through and those that can, pay a small amount on each use to offset that. Coverage should not need to be based on first dollar to last dollar - it is the protection above ability to pay that is the key to having a program that works.
  • Mia about 1 month ago
    Ok people. Concerned about how we "find the money" to fund universal pharmacare ? Here's your answer. A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask?
    Hide replies (4)
    • CGBe about 1 month ago
      Mia, this is the fifth time you've posted this concern on this thread. I get the point that government spends money on many things and sometimes wastes it. Your point presents an interesting issue about governance, transparency and accountability, which is extremely relevant but not so much to the issue at hand: patient cost-sharing. Let's move on and answer the questions posed.
      • Mia about 1 month ago
        Actually, I thought it speaks quite clearly about how we can fund this plan and more by removing our biggest source of waste. Patients do not need to share the cost. Our money needs to be put to better uses like funding the cost of pharmacare. No cost sharing needed. The money is there. The point is, why are we discussing how much we need to cost share and ignoring the biggest sucking vacuum on our tax dollars.
        • CGBe about 1 month ago
          I guess we're discussing cost-sharing because there are different opinions and studies out there that can help us make well-informed decisions about whether we should have it, at what level, with what exemptions, and how it should operate if it is part of the funding mix.
    • cbald 20 days ago
      I see a red astrik. Disregard whatever I did. my fingers are too large.
  • Hd_pharma 20 days ago
    I think having a modest co-pay for drugs is appropriate - people don’t always treat things that are “free” with respect. For people unable to pay even a small co-pay, such as the homeless, other programs could help.
  • Beekay 21 days ago
    Even a small charge represents a barrier to access for many people. Even people above the poverty line but with significant expenses for example childcare often find their disposable income is limited tempting them to delay or skip drug therapy making it less effective.
  • Goddess 21 days ago
    Pharmacotherapy should be universal and free, like our healthcare is SUPPOSED to be vis a vis the CHA
  • Goddess 21 days ago
    Those who cannot afford to pay will not take their prescriptions as directed by their healthcare provider
  • Sickboy about 1 month ago
    Drug costs in Canada represent less than 5% of the spending on healthcare. Let’s have a discussion on the real costs... people! Doctors and nurses consume the vast majority of the health budget annually. I would support a national formulary and ensure that it is universally available across the country. The savings of having one formulary and ease of admin would save money. Evidence based is thon key.
    Hide replies (46)
    • sillverwillow about 1 month ago
      Where is the statistic of 5% coming from? Health care costs are more than doctors and nurses. Other health professionals like laboratory techs, radiologists etc are part of the universal cost.
      • Dinah about 1 month ago
        Let's not forget that doctors, nurses, lab techs and all the rest are highly educated, have to belong to professional colleges, do continuing education, etc. They deserve the money that they make. However, there seem to be just a few too many administrators in the system. It would be useful to fine a way for the system to be managed more efficiently.
        • Sickboy about 1 month ago
          I am not saying the highly educated are not worth the money we spend. What I am saying we are focusing on the smallest cost to the system(drugs). People and bums in seats are the most cost to all of us as tax payers. Admin is duplicated and docs are still paid on a fee for service. It is within their interest and pocket book to keep u coming back. One question or problem per visit is a common practice. Also , no incentive to heal, sick patients are with more to docs
          • Sickboy about 1 month ago
            Doctors get $15 for renewing prescriptions!!! This is ridiculous. A typical pharmacy gets $10 to 15 for filling the med, taking you money, running a business and paying staff. A doc signs their name for a renew and gets $15 ! Now tell me being a doctor isn’t a business ! This is why all Canadians should get a mock bill each year showing what they cost the system for healthcare. I think many would be surprised at what a typical GP visit costs
            • sillverwillow about 1 month ago
              where is this information? is this across Canada? please quote your sources for these stats so we can investigate further
            • Mia about 1 month ago
              You probably think Doctors should be paid like a grocery store clerk? My Uncle is a truck driver: he actually makes more than a GP. Most businesses have no qualms about charging high prices for what they offer . I just had my heating vents cleaned; one hour of work: $300.00; We had an electrician charge us $80.00 for a 15 minute visit ( minimum fees don't you know ), I paid $80.00 for a haircut. Should I go on. Why are you thinking Doctors are making too much. Have you paid a lawyer lately? High education and years of study; we have a bargain actually.
              • Sickboy about 1 month ago
                It is public knowledge what most docs bill. My point was that the biggest cost in healthcare is people. Debating drug costs is never going to heal this issue. It represents the smallest portion of what our tax dollars are spent on.
              • Sickboy about 1 month ago
                My other point is everyone should know what the visit to the doctor actually costs. We know drug cost because it is presented. Most people have no idea that doctors are paid on a fee for service schedual. Sick people make them more money, healthy people do not add to their fees. That in my opinion is a broken system to incentivize people for patient churn and not keeping them out of the office
                • Lise King 29 days ago
                  Doctors are in the business of healing not social calls... They have more patients then they can handle... People do not think going to the doctor as a social event that they cannot wait to visit... We go when we have no choice and sometimes the wait is so long that we end up in emerge, for the symptoms worsened to critical... Most people know doctors are paid on a fee for service schedule...I do not understand where you are coming from?
                  • Sickboy 29 days ago
                    Where I’m coming from is an insider to the healthcare system. Follow the money always and every time. The system is strained do to limited funds. People use 80% of their health care dollars spend in the last years of their lives. Doctors have billing codes for each and every thing they do. Why not pay doctors a flat salary to keep us healthy? Every time this is proposed, doctors fight it. They want to have limitless billing opportunities. Of course not every doctor thinks or works like this, but more and more the newest grads are lifestyle doctors. They want to bang out patients at walk ins and bill huge dollars. They don’t want to work evenings, weekends or rural areas. Check the public annual published Billings for doctors in your province. It is easy to identify the long list of abusers. GP’s billing 400k or more annually. Im coming from the reality that it is a limited pot of money!! Let’s get this straight, we cannot continue to over spend and borrow against future generations. I work to keep myself healthy and my family. God forbid we get a terrible disease, however that’s why I pay my fair share. I don’t expect to see a doctor and continue to smoke, not exercise and wonder why I’m on poly pharmaceuticals and expect society to cover the bill.
                  • Audrey 28 days ago
                    Seniors sometimes go to the doctor everyday because they are lonely and have no one. You are quite wrong. The emerg is full of people with the common cold. Get real. Tons of people go to doctors for nothing and ask for prescriptions when they don’t need them. Have you heard of placebos?
                    • pambeach 24 days ago
                      A small fee ($5) for every visit will reduce unnecessary visits to dramatic low numbers. Annual Govt. budget will reduce dramatically and doctors shortage will resolve. This may bring MSP premium to $0 for everyone.
                • Dinah 29 days ago
                  Ontario has been moving to a capitation system slowly over the last years. My previous doctor was part of such a group. This actually incentivizes doctors to keep patients healthy and out of their office. However, this discussion is not really meant for this forum!
            • Dinah 29 days ago
              I don't think that GPs are overpaid. They do run a business, lease space, pay staff, etc. It all comes out of that $15 for prescription renews, etc,. However, I have always thought a mock bill would be a good idea. But it's the specialists, hospital stays and ER visits that would really knock your socks off!
              • Sickboy 29 days ago
                I am not suggesting they are over paid. I am suggesting people know what their drugs cost because they see the bill. We should see a mock bill for all our healthcare touch points. I personally know of doctors that charge a visit fee for all prescription renewals, why they ask you to come in and won’t do it over the phone anymore. This is a ridiculous practice and costs the system huge dollars. All chronic meds that a person is stable on should be auto renewed by the pharmacist.
                • Audrey 28 days ago
                  Well said!!
                • Dinah 28 days ago
                  You are quite correct. That is the situation in Ontario anyways, as phone advice is not an insured service in Ontario (never mind any newer technology!). We pay our doctor's office $160 per year to get renewals by phone or fax. Between us we have enough chronic diseases to make that worthwhile. Everyone hates this, but the province hasn't been able to get all practices on to a better model. Again a discussion best to be held elsewhere, or I'll get into my e-Health diatribe again.
            • Audrey 28 days ago
              Wow. I didn’t know. You are 100 percent right. But will most people care??
          • Mia about 1 month ago
            Doctors are mostly overworked. Here in Ontario people are waiting years to find a family doctor. We need more of them, badly. They are most decidedly not interested in 'keeping you coming back' to get your visit fee. The "one question or problem" thing is because the waiting room is packed and they need to get through them all. Make another appointment so others can get into the doctor themselves . As it is, you wait a long time to see the busy, overworked doctor. We need to respect these people. They work long, hard hours. They worked hard, for years just to become a doctor. "No incentive to heal "??? What exactly are you basing that proclamation on?
        • Mia about 1 month ago
          Ok . for you Dinah, then I'll stop repeating this though I hope everyone passes this info on: Concerned about how we "find the money" to fund universal pharmacare ? Here's your answer. A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask?
          • Dinah 29 days ago
            Have you got references for any of this? I thought the Bank of International Settlements was there to pass through international payments in various currencies.
      • Sickboy about 1 month ago
        Annual health survey that is done every year or two in Canada. Approx 15 to 20 % spent on bricks and mortar, 5% drugs and the rest on people / salaries etc. fact remains the smallest percentage of the national/ provincial budgets spent on drugs, however it’s the easiest target to cut year after year. If we cut salaries and admin by 5% we would save a lot more money
        • CGBe about 1 month ago
          Source?
      • health reform observer 21 days ago
        Prescription drugs represent 15%, not 5%, of total health care costs, the same as physicians services. It is easy to check on CIHI's website. Another reason to worry is that these costs will likely increase faster than those of other services in the coming years.
    • CGBe about 1 month ago
      In 2017, prescription drug costs are forecast by CIHI at $34 billion, 14% of total health spending of $242 billion.
      • Sickboy about 1 month ago
        So we just blew 15% of the drug health budget buying one pipeline?
        • Audrey 28 days ago
          Excellent point! Very sad story indeed.
    • keithmnop77 about 1 month ago
      Exactly right SB, although I figure the 5% is way off. We have the eighth highest health care spending in the world, after the USA, Norway, Saudi Arabia, and some tiny countries like Monaco where every procedure is an "out of country" expense. But at the same time we're #30 or 31 in life expectancy. / We're doing better than the USA, but worse than France, Japan, etc., etc. Pretty much, of *highly* developed countries we're doing better than the USA and that is it. / But how do we tackle nurses' unions and doctors' cartels? I don't think it can be done. I think it is a waste of time to even talk about it. // I agree about the formulary.
      • Sickboy about 1 month ago
        I suggested giving each person a bill each year showing the costs involved in doctor vists, lab test and procedures. We only complain about drug costs because we see what they are !!! Let people know that the five minute visit to discuss one problem with your GP and get a renewal on your prescription cost 300 to 400 dollars and people may start to complain about value for money spent on healthcare. I refuse to say unions are too powerful so let them charge anything they want. Ultimately we have one pot of money and we cannot continue to spend more than we bring in. Just like your paycheck, if you overspend you go bankrupt
        • Mia about 1 month ago
          Then lets cut costs elsewhere Healthcare is too important. By the way; you are very wrong about that cost for the doctor visit. Where did you get that idea for a cost? Cut useless NATO; cut subsidies to wealthy corporations and businesses ; cut the interest to the private banks when we the government can instead borrow interest free from the Bank of Canada; cut supporting US wars; on and on and on; lots to go around.
          • Lise King 29 days ago
            Let's get rid of the senate, cut the wages of politicians, travel expenses... pensions... then the healthcare system would become the state of the art healthcare system...
            • Dinah 29 days ago
              Here we go again! The actual pay stubs of the people in the Senate and the House of Commons are minuscule compared to the overall expenditure of the federal government. They are just more visible. The biggest expenditures are money transfers to people and interest.
            • Audrey 28 days ago
              You are correct. Now you are targeting the real, visible, known waste. Trudeau has made many promises he didn’t keep. Mayor Tory flies around the world... on us.
        • Lise King 29 days ago
          That will add to the cost of healthcare... The money spent on private insurance to be moved to public insurance... and no more two tier system...
      • Mia about 1 month ago
        "Tackling nurses unions and Doctor Cartels". Good Lord! Very amusing of you. Quite the inflammatory labeling there. We don't need to 'tackle' nurses unions; maybe YOU need a union. Every worker should have one; don't be jealous; all workers have that right to form one. You're not a serf; form a union yourself. Just the fact that you have a reasonable work hours and week, and overtime pay, and can expect a safe work environment is all thanks to Unions. All workers benefit from their gains. And Doctor Cartels? Very odd term that seems pretty irrational. You really worry about the wrong people.
        • Audrey 28 days ago
          Unions are under attack. Why do people in unions get to earn twice that of private workers? She is right - they are cartels.
          • Dinah 25 days ago
            More people could be in unions, and then pay would by more fair. However, a lot of people are too cheap to pay the union fees, for one thing, and employers are very good at scaring their people from joining a union.
            • Suzieque 25 days ago
              I've worked in both, union and non-union. Generally union wages are better, but not always; why would people be too cheap to pay union fees if the wages were so much better. Actually, some choose not to belong as a matter of principle; they don't like being coerced into joining anything. It's clearly evident in the professions that I worked in, that there were far more abuses of privileges such as time-off in union workplaces than in private industry. There are pros and cons to everything including union and non-union workplaces.
      • Audrey 28 days ago
        It would require government fortitude. Is there any?
        • Suzieque 25 days ago
          Good question. Although each political party has some basic principles; I believe they exploit these principles for votes. Currently that applies to National Pharmacare and it's primary Universal healthcare and Labour(Union) advocates and the Agencies they support, such as Senior Citizens, Government Retirement and Pro Universal Healthcare groups. Everyone may benefit, or not, depending on how inclusive the formulary is (for those with low incomes) and whether Government pharmacare will be as inclusive as "some" private pharmacare benefits.
    • HW 29 days ago
      Actually, according to CIHI's National Health Expenditure Trends, 1975 to 2017, (https://www.cihi.ca/sites/default/files/document/nhex2017-trends-report-en.pdf) total health expenditure was expected to reach $242.0 billion or $6,604 per Canadian in 2017, the split including: Hospitals (28.3%), drugs (16.4%) and physician services (15.4%).So drugs do contribute to costs, though a lot less if the government were in a position to negotiate lower costs with pharmaceutical companies. However, I am not very keen on the co-payment idea, on the KISS principle. Once you have co-payments, you have to waive them for those who really can't afford them, which takes a bureaucracy and administration - and that always costs.
      • Audrey 28 days ago
        So someone does have the numbers and yes prescriptions cost more than physicians. This indicates that prescriptions do need a big overhaul.
      • Dinah 27 days ago
        What on earth is that other 39.9% being spent on? Home care?
        • HW 25 days ago
          https://www.cihi.ca/sites/default/files/document/nhex2017-trends-report-en.pdfThe report tells us 'Drug expenditure growth fastest among 3 largest health spending categories'. It goes into what the other 40% is spent on in some detail after summarizing 'Health dollars are used to purchase health care goods and services, to provide capital investment, to administer public and private insurance plans as well as public-sector health programs, and to fund research.'
          • Dinah 25 days ago
            Now see I would have included any purchasing of goods and services and capital investment (buildings I guess) within the sector that is purchasing/building them. The administration of insurance makes sense, as does public health, but research really should not be included as health care, and I say that as someone who used to work in research (we were funded by grants).
  • cbald 23 days ago
    First I do not believe in a Canadian pharmasave system. Keep it provincial. Everyone should be able to get their drug of choice. They need to take that works for them, not what the majority of people take. Your study was done only Ontario ... not truly what is happening across Canada, is it? Please do not ask us to accept what works for your province as it may not work for the other nine provinces. If the federal government chooses to pay for complete coverage for indigenous and new immigrants, then separate their medical costs from the paying patient, as it is the governments choice to do this. Not fair to penalize others. If these people paid taxes it would help offset costs. The indigenous have 50 plus “billion” dollars to invest (with two companies from China) in building a new refinery in Alberta. If these people were doing so poorly then who is in charge of these billions of dollars they have available for investing. (They are also building a pipeline). They announced they are investing in the oil refinery so the profits they receive will help their people. So sad that only half the story is ever reported.
    Hide reply (1)
    • health reform observer 21 days ago
      New immigrants pay taxes, as the rest of us, and are usually healthier than the average Canadian (this is called the healthy immigrant effect), therefore they cost less. Otherwise, I am not sure why patients in BC would differ that much from patients in Ontario that they would need their very own plan with very different drugs.
  • FeelTheBern 23 days ago
    I believe that all patients in Canada receiving oral medications outside of the healthcare system as part of their ongoing healthcare, should be able to receive their drugs through a National Pharmacare Program. This is particularly important for patients receiving specialty drugs which are usually very costly. The current patchwork of drug reimbursements in Canada means that many patients have to pay large out of pocket co-pays, rely on a patchwork of employer based insurance programs, or partially funded provincial programs which are not equitably sustainable or accessible to all Canadians. Additionally, patients are forced to rely on third party programs to help them reduce their co-pays for these medically necessary expensive drugs. We are aware that the model for receiving oral cancer medications, for example, directly through hospital pharmacy already works, as this is what is happening in B.C. This should be available to all Canadians. Canada is the only OECD country with a national healthcare program that does not have a national pharmacare program. As Canadians, we all need to finish what Tommy Douglas started, we need to have a national healthcare program that includes a national pharmacare program.
  • Mofrob about 1 month ago
    There are no benefits for paying for the cost of drugs. All assumptions for paying or copayment are made on the precepts the people will abuse the system. No one I know taking drugs for medical reasons abuse the use of their drugs.
    Hide replies (25)
    • CGBe about 1 month ago
      Good point, although clearly we have an serious abuse problem with opioids. There is considerable documentation about inappropriate prescribing, and about billions wasted by patients who fill prescriptions but don't take the drugs (adverse effects, poor adherence, etc.), or take expensive (brand) drugs when others (generics) will provide similar results, or pay the highest cost for pharmacy dispensing when the services are regulated and the same everywhere. These are all opportunities to save money without harming patients. If no one pays, they become insensitive to price and cost signals. It can't be a blank cheque - pharmacare is an extremely expensive (but good!) program and we need to save money where we can.
      • keithmnop77 about 1 month ago
        1. When purchased legally, aren't most actual opioids low cost drugs, in terms of what they cost per day. They're out of patent and any company can make them. / 2. Not taking a drug that makes you more sick instead of less isn't billions wasted. The doctor prescribes a drug that works for most people, it doesn't work out. The patient is told to stop taking it. Medical trial-and-error is much cheaper than formulating and administering some kind of genetic test to pre-determine if the patient will be able to handle the drug. (Although I understand that genetic pre-testing is done with some cancer chemotherapy drugs. I think that mostly has to do with the patient not having enough time left for the traditional trial-and-error method of finding the right drug.)/ I don't like to ask for links, but in this case yes please for this: "There is considerable documentation ...". / 3. If there is inappropriate prescribing then the deductible would have to be paid by the doctor to have an effect. / 4. I think it goes without saying, and I totally agree, that pharmacare should, as it does in Manitoba, cover the price of the lowest cost generic. / 5. National pharmacare should only cover the cost of new (actually riskier) drugs after older reliable drugs have been tried and failed. This is how it is with Manitoba's pharmacare and its EDS system. If the old drug has been tried and failed, or if the patient cannot take the old drug for medical reasons, the physician faxes a request for coverage of the new drug to Manitoba pharmacare with the reason for extended coverage./ 6. I agree that pharmacare should follow the practice of group health insurance and have maximum dispensing fees.
        • CGBe about 1 month ago
          Regarding inappropriate prescribing: This concept is periodically studied in several countries, including Canada, the US and the UK, though each system is structured and funded somewhat differently. There's a new study being done in Ontario described here: https://bmjopen.bmj.com/content/8/6/e021727. It used a term I didn't know: potentially inappropriate omissions, i.e., when a prescription should be provided that isn't. All part of appropriate prescribing though. Here's another reference in CMAJ, that also provides a link to an earlier study by Steve Morgan (UBC): http://www.cmaj.ca/content/189/19/E706. Morgan et al.'s study estimated 37% of older people filled 1 or more prescription inappropriately costing $419 million in 2013.
          • CGBe 30 days ago
            Re: inappropriate prescribing, here's a quote from the HESA report, p. 57. It's attributed to Dr. Anne Holbrook, McMaster: "As a result of inappropriate prescribing practices, the Committee heard that 300,000 Canadians suffer serious, disabling or fatal medication-related harm annually and 20% of Canadian medical malpractice cases relate to the prescribing of medications alone." With 13,000 drugs on the market, physicians are bound to make mistakes, and some of those cause serious harm.
          • Lise King 29 days ago
            Re: inappropriate prescribing, that responsibility should fall on the physicians for the patient depends on their physicians to help them with their illness, if not even cure them... They expect the physician to know what is best for them... Quite a few times a pharmacist stepped in for the doctor would have killed me with over prescription or a prescription that has ingredients that I am allergic to... I will never forget the one that would have fried my liver... That was scary... The list goes on... Physicians and pharmacists should work as a team to ensure the patients are getting the best care possible, help eliminate over prescriptions, and allergic medications. No drug companies should be allowed to offer incentives to either physicians, nor pharmacies to prescribe their brands. The focus should be base on what would be best for that individual person...
            • Dinah 29 days ago
              I really think that this discussion is supposed to be about paying for drugs and we have go way off topic by getting into appropriateness of prescribing, which is a valid topic but should be discussed elsewhere.
              • CGBe 29 days ago
                Agreed, but I could get the info fairly quickly and it was tied to discussion about waste in the system. Better managing (reducing) waste helps reduce cost, including patient/citizen cost-sharing. It's also tied to the need for modern administrative systems that can surface and mitigate wasted spending by prescribers, labs, institutions, patients, etc.
                • Mia 28 days ago
                  ????Again; inappropriate prescribing is not much of a reason for making people co-pay. It is off topic I'm afraid.
            • Audrey 28 days ago
              Pharmacists should not exist. It would be cheaper to have a centralized filling company (sort of an Amazon). Computers can do the work better. I’ve had ridiculous issues with pharmacists. That would save everyone a fortune.
              • Dinah 28 days ago
                As someone mentioned above, pharmacists save lots of people from something their doctor prescribed that they should not be on. They seem to be better at the interaction of drugs bit. Also, they make sure that the drugs are picked up by someone responsible. I don't think we want drugs being dropped off on doorsteps by drones!
              • Mia 28 days ago
                Wow. Quite a major reaction to whatever your experiences with a pharmacist might be. Get rid of pharmacists? Holy cow. Are you sure you know what pharmacists actually do. I for one WANT that pharmacist; they are extremely valuable. You are actually thinking getting rid of pharmacists and replacing them with a COMPUTER is reasonable? (Actually, I for one have had RIDICULOUS issues with computers. Lets get rid of all computers. Actually, I think more people have probably had ridiculous issues with computers than with pharmacists.) My pharmacy compounds a medicine for me because of my reaction to the usual combo in it's makeup. I rely on my pharmacist to know all about the medicines he is preparing ( they are highly trained you know; they don't just work their way up from being a store clerk) he tracks my meds, he portions them out according to my prescription, and even cut pills as required to place them in proportioned bubble packages so they set out my portions for each day , weeks, for a whole month, and he checks all prescriptions for interactions with each other. He advises me on any over the counter drugs I want, and checks if those interact with my prescriptions. And more. Much more. Imagine the disasters and lack of service and pertinent knowledge if we were relying on computers. ( Gee what's your plan when the system is down? No meds for you. )How about we all try to think really rationally about our statements. You know, lets ask ourselves: how reasonable is this comment before using that keyboard. Inflammatory remarks, especially about an entire profession, are not helpful, and a bit unpleasant. .
            • Suzieque 23 days ago
              Prescribing is an important element of Pharmacare from a cost perspective. A patient prescribed a costly medication by specialist went to family doctor for a substitute at a cost one-third the specialist's prescription. Another patient prescribed a medication on an ongoing basis by specialist with no substitute available. Unless the prescribing doctor takes responsibility for ensuring that a medication is covered by Pharmacare, it's the patient who is left with the dilemma of how to pay/fill the prescription and may do without if it's unaffordable. Should there be some guidelines for physicians to ensure that the medication prescribed is covered by Pharmacare?
          • Mia 28 days ago
            This is probably more of a reason to stop letting pharmaceutical companies dictate any aspect of Doctor's training in Universities ( which in the States is rampant; they fund ; they dictate ( and of course the agenda is selling more drugs). This argument of yours speaks more to that then as a reason for making people pay for medicine. And what do you mean older people "filled a prescription inappropriately???" They don't fill them, or write them. They probably don't even know exactly what the drug is ( in spite of the individual consultation every person gets at a pharmacy when they bring in a prescription to be filled). Overall; it seems your concern is for a different topic ( doctor training; pharmaceutical companies dictating doctor training; something like that).
        • Lise King 29 days ago
          I myself have severe allergic reactions to certain drugs that contain certain ingredients that I am allergic to... I cannot take some generic medication and must have the brand name drug. It would be devastating if that option was not available...
      • Mia about 1 month ago
        We are talking about people who need medicine because their doctor prescribed it, presumably for a condition or illness; it is difficult to see that scenario as a 'blank cheque'. People are not shopping; they are sick and need healthcare. Concern about sick people who need healthcare becoming insensitive to price and cost seems to be a bit of a stretch. When my Dad had open heart surgery we did not research the cost, but I also do not think we were joyously becoming insensitive to it either; we had other things on our mind; kind of like when my husband takes his blood pressure medication; if we are not paying; I don't think we'll be "insensitive" or carelessly take the medication, (or however 'insensitive to it's cost' might be done ); we have other concerns: like trying to control a serious condition. That's sort of how it works when you have to take medication. Maybe you are thinking Doctor's will prescribe drugs carelessly then? But then they are regulated. Having trouble envisioning how prescription for medication,and "insensitivity to it's cost", would actually look like.
      • Mia about 1 month ago
        All drug programs ; especially government funded ones, require generics; if you want the brand name you pay the extra cost; not the government.
        • Lise King 29 days ago
          There are exceptions to that rule, if you have an allergic reaction to the generic drug they will allow the brand name... They do not want to get sued for making you more ill... or worst kill you...
        • Audrey 28 days ago
          This is absolutely true.
      • Sickboy 29 days ago
        People should always be made to pay something. I personally know of people that are on social assistance and third party coverage that collect points , airmiles/ optimum point etc of drugs the government pays for. In many cases they do not need or even take the meds but do not want to discontinue because the rewards points given are so lucrative. This may be a manitoba issue but it is real and exists. A national program should stop any incentive for getting drugs filled period. I cannot understand why it has gone unchecked in this province for decades
        • Mia 28 days ago
          Removed by moderator.
        • Dinah 27 days ago
          For a short period you could get Shoppers' Optimum points on your prescriptions when that reward program was brought in. The Ontario College of Pharmacists put a quick stop to that.
          • Sickboy 27 days ago
            I know that is the case is some provinces. Unfortunately not in manitoba. The abuse is ridiculous and no one sees to put a stop to it. I would relate this to govent employees that collect areoplan and west jet points on flights paid for by tax payers. These types of incentives should be stopped across the board unless u are spending your own money
      • cbald 23 days ago
        If cost is a big problem people would not be filling their prescriptions and not taking them. Makes no sense.
    • Audrey 28 days ago
      Anyone who believes drug prescriptions aren’t abused is dreaming. An injection of Lucentis in the eyes is over $1000 yet because it is free, the hallways are lined up for it for four hours - in the “hope” it works, even though it works less than 50 percent. There will be some difficult decisions to be made. Are newly arrived newcomers eligible? Are residents eligible? My mother lived in the US for a few years although she’s been a Canadian all her life. When she returned to Ontario, she had to wait three months for a health card - just long enough that she went blind. Think about it!
      • Mia 28 days ago
        Sadly your mother didn't read the information provided. First of all; she would still have been covered as a Canadian by her last province of residence for that 3 month interim. They TELL YOU to get private insurance for that 3 month period that your last province normally would have covered ( the interim) before the new province's healthcare kicks in if you apply after a longer length of time between moves. I know; I just moved from BC. Sadly, She cost herself her eyesight. And if she was indeed a Canadian living in the States, she is still covered for healthcare if she returns to her last province of residence every 6 months and continues to pay the nominal premium ( like $43.00 a month) . All of this info is easy to find. Very surprising she didn't do these things. All the 'snowbirds do of course. When you apply for your Ontario health card all of this info on covering the 3 month interim is in the package. I was covered by BC for those 3 months. (I made sure I applied for it immediately too. If you leave it; you still have a 3 month interim and the worry then is that your last province only covers a 3 month period when you move. Then you'd need to buy private insurance for the neglected time period). Canadian citizens are eligible ( from birth they have coverage and it goes with them through life; not 'newly arrived newcomers' ; unless you fit the terms as refugee status.
  • drugsforK 23 days ago
    Note everyone is fortunate to have a job with benefits. More and more people are on contract and do not have any opportunity to pay extra to by private insurance. The cost of living is tremendously high and most people are just trying to make ends meet. People with very serious illness may have debilitating costs associated with drugs that can prevent longterm impairment.
  • bcjcw1 24 days ago
    Lots of vulnerable people have multiple meds and few resources. Co-pays and annual deductibles become impossible to pay. People get sicker, and then everyone pays for hospitalization.
  • Postiesue 24 days ago
    Benefits you have coverage. Drawback is that the co pay part can be too expensive, for example if someone has a lot of medications or has a very expensive drug like a cancer treatment.
  • pegleg 24 days ago
    I renew my prescriptions every 3 months where possible. I often have to fill out forms for the province and of course keep track of the payments with insurance company. I am now feeling like I need accountant assistance with this aspect of the procedure. I also have had trouble with a difference of understanding and perception of what I am talking about with the personnel at the insurance company. I know this sounds like a racist comment but I suffer from the frustration of differences of cultural understanding between us when we are discussing some situations. I believe personnel needs to have some understanding of cultural differences in language to deal with the frustration of customers such as myself. It often ends up in my feeling "to heck with it" and going without the money. However because I don't have a cost of living supplement to my pension I am finding it harder and harder to keep up with inflation and dislike the problem of dealing with people from other cultures who are also frustrated with language difficulties. The education we as a nation offer to immigrants needs to be made more usable for these people.
  • pambeach 24 days ago
    Benefits: Less misuse and less wastage.Drawbacks: Some drugs are very expensive and unaffordable.
  • Anthony041 25 days ago
    As a retired physician I'm experienced as a prescriber in Ontario - and recently began to use prescribed medications for the first time; therefore I can now speak as a user of OHIP. I'm fortunate to have post-retirement private health care coverage - a benefit afforded to only a small minority of retirees. Thus 55% of $15,000 (of which $500 were prescription charges) in our total family health care costs last year were covered by private insurance. We are both pretty healthy and I suspect these costs may be representative.The question of payment is complicated by the fact that older persons become prime users of drugs for chronic, - common - medical problems but have fairly fixed incomes. I'm in favour of some degree of cost recovery, and the OHIP does that well - and fairly. I'm in favour of the drug cost recovery being somewhat income-dependant, but it needs to remain a small fraction as non-drug health care costs are rising and significant in the older segments of the population. Funding for National Pharmacare should be drawn from the federal tax base across the whole of society, with some degree of user fee embedded in the prescription payment at the Pharmacy.
  • Ddclearwater 26 days ago
    I don't think there are any drawbacks. The drug coverage is deducted at the pharmacy and you just pay the difference.
    Hide reply (1)
    • Johnny Pistola 26 days ago
      My wife and I live on a combined pension of about $2000/month. From that we pay over 10% (>$200 monthly) for Blue Cross and BC medical fees. Then we spent an additional $150/month on co-payments for prescriptions. You don't have to be a math whiz to realize that seniors like us, with relatively good pensions, can't get by under the current system. Add to that the ever increasing cost of drugs to us on fixed income and you can understand why so many seniors choose to go without life saving prescriptions.
  • IrisGorfinkelMD 26 days ago
    Currently doctors have little knowledge of drug costs. As a result, overly expensive drug choices continue to be selected. Expensive drugs with little to no added benefit are harmful to patients and their families. Patients' inability to afford drugs is one of the top reasons why prescriptions go unfilled. Unfilled prescriptions in turn raise costs on future clinic visits, emergency room visits and hospital admissions. Overly expensive prescribing would also erode sustainability of National Pharmacare. It is imperative that our National Pharmacare program provide doctors provincial formulary drug costs automatically at the point of prescribing. Doctors need to be provided with cost information to make fiscally sound, sustainable choices when prescribing. Cost-effective prescribing is impossible in the absence of knowledge of drug costs.--> See the article published in the peer-reviewed Canadian Medical Association Journal entitled, We Need to Mandate Drug Cost Transparency on Electronic Medical Records at https://doi.org/10.1503/cmaj.171070--> Sign and share the petition: https://www.change.org/how-much-is-that-drug Iris Gorfinkel, M.D.i.gor@outlook.com
  • Buffy70 about 1 month ago
    There are no benefits to individuals having to pay a portion of the cost of their prescription drugs or making co payments. If your going to have a national Pharma care plan to benefit all Canadians it need to be free for everyone. Once you start paying a portion of the cost the percentage will increase over time until it is no longer viable for those in lower income levels.
    Hide reply (1)
    • Dinah 27 days ago
      I think what you are saying here is, if we put this in as no co-payments or deductibles, it is harder for a subsequent government to bring them in. If there is a low level of either, future governments can increase the amounts of both/either, whenever it suits them.
  • Valerie Smith about 1 month ago
    Many of us could make a small payment towards a prescribed drug, but many cannot. Many years ago .. ... raising two children and working, I could not join the other office staff to go for coffee as didn’t even have ten cents til payday... which is probably like two dollars now? Also might depend on how many prescriptions a person or family gets a month. Now I can, I am willing to pay a nominal fee. PS I have two unused prescriptions here which cannot be returned for safety reasons.. if sold in a sealed container I could have donated unopened pkge. back to pharmacy for someone in need.
    Hide replies (6)
    • Dinah about 1 month ago
      That's odd. In Ontario you certainly can take unused portions of prescriptions back to the pharmacy. I just did that a couple of weeks ago because of horrible side-effects. They took it gladly and put a note in their computer not to ever give me that stuff again.
      • leslea_kate about 1 month ago
        In Alberta it's illegal to reuse prescription medications due to the risk of contamination. For example an antivaxxer that doesn't know they have measles, sneezes while the pill bottle is open... That'd be a nasty surprise to anyone else who took that "unused medication" who happened to also be unvaccinated due to having a medical condition that precludes them from having the vaccination.Safety with medications means not reusing them for other people.
        • Dinah 29 days ago
          I'm not saying that they reuse them!! But they are responsible for disposing of them safely and keeping them out of our environment which is what happens when people flush them or put them in the garbage.
      • Cats Corner 29 days ago
        They will take the drug back then dispose of them. Previously dispensed drugs cannot be reissued
        • Mia 28 days ago
          So you don't get refunded of course.
          • Cats Corner 28 days ago
            of course
  • Suzieque 28 days ago
    Ideally, all medications prescribed by doctors would be covered under Pharmacare. The reality is that all drugs are NOT covered raising the question of out-of-pocket costs. This is happening now, too often, and will continue with National Pharmacare to a greater or lesser extent depending on which formulary is implemented. These non-formulary drugs can range from $20 to thousands upon thousands of dollars. I'm not reading anything in the discussion paper about how to pay for these drugs so assume they will continue to be "out-of-pocket" as they are now. For those that can't afford these extra costs this is a major problem. I'm in favour of paying a portion of our drug costs, depending on our income, to keep the system sustainable and ensure there is some funding available for those that cannot afford these out-of-pocket costs, either due to an extraordinarily high drug cost or even a minimal cost, depending on one's financial situation.
  • Robert in Vancouver about 1 month ago
    If you are between 18 and 65 and completely capable of earning money but choose not to, then I'm not willing to pay for your medicine or any of your other needs for longer than 3 months. If you are fully capable of working but in between jobs, 3 months is enough time to find a job. Government should not be using any tax dollars to pay for medicine for people who can work but choose not to.
    Hide replies (12)
    • Dinah about 1 month ago
      These days it does not seem to be a choice to not work, or to be poor. Plenty of people who are working are living under the poverty line and don't have any extra money to pay for medications. Employers are keeping jobs part-time to avoid putting people on benefits. Lots of people are combining 2 or 3 jobs, non of which have benefits, just to keep their heads above water. Not that medications should cost hundreds of dollars either.
    • Mia about 1 month ago
      You need to move to the USA. They think like you; hence the sad situation for most people in that country.
      • Robert in Vancouver about 1 month ago
        So Mia, you obviously think it's OK if there's no money left for people who really need help (old folks, handicapped people, etc.) because it's been given to people who are perfectly able to work but choose not to.
        • Mia about 1 month ago
          No Robert. I think if you have done some reading, that you would see the numbers have already been crunched and it is LESS COSTLY to do a universal healthcare system for drugs; all the other costs bureaucracy would be eliminated and actually save money because multiple programs and the high cost of running them are eliminated. "People who are perfectly able to work but choose not to"? Really. And what magnificent, costly bureaucracy is going to be devised to evaluate all of everyone and choose those worthy of coverage and those who are 'perfectly able to work but choose not to'. So only 'old folks, and handicapped people' fit the bill? So to you everyone else is undeserving? I am retired. I pay a LOT every month to a private company for extended health coverage. In 3 years of paying them every month they have covered NO DRUGS for me or my husband because their deductible is so high. They then expect the government programs to cover 1st; then them. I keep paying because of IN CASE we get sick and can't cover the costs of expensive drugs. So LOTS of money to them and NO COVERAGE. We are retired. Our income is modest. This private coverage represents a big chunk out of that modest monthly income. There is more to this scenario than " people who are perfectly able to work but choose not to". I DO NOT want Canada to become the greedy, self centred, callous society that is found in the US. Lets take care of each other; everyone; even those few who could work but "choose not to". Really , where do you get the idea those people are rampant anyway; and if there are some, is that really a reason to punish EVERYONE else and deny a reasonable and sane pharmacare program. Here's a though: how about we stop funding US warmongering and that dinosaur that is NATO ( really a posse to enable US warmongering), and how about we look at this as a source of revenue ( a mega source):"You know the old aphorism -- “If a tree falls in the forest...?” Well, how about this one: If citizens win a significant victory in court against an autocratic government involving the fleecing of Canadians of billions of their hard-earned tax dollars and no one in the media actually covers it, did it really happen?That might well be the question being asked over at the Committee for Monetary and Economic Reform (COMER) a very small and low-budget Toronto think tank. With their lawyer Rocco Galati (of Supreme Court fame in the Marc Nadon case), they have been steadily winning court battles initiated in 2011 that would oblige the Bank of Canada to return to its pre-1974 practice of lending the government money virtually interest free. " This was the original mandate of the Bank of Canada until corporate and shareholder's interest's overrode that of Canadians and we now borrow from Private banks as a country and pay their interest fees. Hence our huge debt load. Google it. It's quite the eyeopener. So YES indeed, we CAN afford universal pharmacare if we get the banks off of our gravy train. Want to talk welfare: there you go; the biggest welfare scam going. Really. Google it. Why doesn't everyone know this. Why pick on some poor slob who "can work, but isn't" Please.
          • Robert in Vancouver about 1 month ago
            Mia, didn't you read my post? I used the word etc. when describing who should get help. As far as deciding who should get 'free' medicine, we already have such a system in place. People who need welfare have to get approved by a gov't agent. The same gov't agents who do that would also decide who gets 'free' medicine.
            • Mia about 1 month ago
              Here's the answer to your concerns: ( I don't think you read my email):PETITION TO THE GOVERNMENT OF CANADAWhereas:Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. Please do google it. As I said: this is the biggest rip off going. And it's not some guy who " can work, but chooses not to". The magnitude of debt we all hold due to this gross arrangement is where we should be all looking. There is a public movement to restore the Bank of Canada to it's original mandate and get the private banks off of the gravy train. Now THIS is what outrages me. Really. Here's the money for everything we need. We, the undersigned, citizens of Canada, call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures.We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare.
            • Mia 28 days ago
              Robert. It's not 'free'. Everyone's taxes will pay for it. So if we all pay into it, it's wrong to not cover everyone.
        • keithmnop77 about 1 month ago
          You aren't one of those seniors who doesn't want to share the benefits, who thinks that young parents are less worthy of coverage than our fellow seniors. Greedy seniors fighting universal medicare for all down in the USA was the most shameful episode of American history since failing to prosecute the war criminals at Mi Lai.
          • Mia about 1 month ago
            "Greedy seniors"? Really? Are there Americans on this board. Come on. Fess up. Universal healthcare means these seniors are still covered dear. I think you are repeating nonsense you heard from somewhere or other but it is pretty lacking in actual fact. Personally, I think the most shameful episode of American history has been their ongoing illegal invasions of other sovereign countries and CIA interferences in order to "destabilize" other countries in order to further American interests. The list is extensive. Gee, even Tulsi Gabbard, a US senator has a bill before congress that seeks to "limit US arming of terrorists in other countries". Actually the list of "most shameful episodes for America is pretty darn long. All those sanctions but not one word when Isreal used phosphorous gas on unarmed Palestinians, and machine gunned down unarmed Palestinians holding a march on the Gaza strip. The uninformed commentary is concerning.
      • keithmnop77 about 1 month ago
        Actually Mia, the USA has programs (Medicaid) for the extremely impoverished and for those whose income is purely black market. It is the USA's middle class and working poor who suffer under their sad situation.
        • Mia about 1 month ago
          I don't care about America and it's programs. The point is we DON"T want to be like their sorry state of healthcare affairs.
    • keithmnop77 about 1 month ago
      Robert, what kind of job do you have that you can afford $30,000 a year for drugs, because that is what you are saying ordinary people should be able to do. / That said, I agree that people who can work should work.
  • bcpokharel 30 days ago
    My opinion is that:We all want justice and justification on the issue of paying prescription drugs.For those Canadian who earned a very good salary in their whole life or have very good pension because of good income and length of service reciprocates the CPP have no difficulties paying for prescription drugs. however, for those canadians who did not have good salary and did not work long enough of years will not get a good pension or CPP that leads to the financial difficulties for paying prescription drugs.This also applicable to those who are unemployed or underemployed. The committee or agency who prepare the bill for passing at the parliament ought to think this very seriously keeping in mind the justice and humanity.
    Hide replies (3)
    • bcpokharel 30 days ago
      This is a very good idea to follow while preparing bill at the parliamentary committee.
    • Mia 28 days ago
      Everyone who pays taxes will be paying for the program: hence even the people with a "good" income deserve coverage ; as they will be paying the most. Unless of course you are suggesting they are exempt from paying through their income tax because the money will be going to pay private insurance ( so lower their taxes accordingly; a bit inefficient that would be, but fairer). Or are you suggesting they pay twice ( for pharmacare through taxes, and for private insurance; but are not allowed access ). Fairness ( Justice and humanity)is important as you say. For everyone.
      • Mia 28 days ago
        You know;some people have a 'good income' or a pension, but still worked hard their whole lives to get what they have. Studying in school, training, saving, on and on. Some with jobs with very heavy responsibilities too. I don't think it's right to think because someone has a 'good income' or a pension , that they never get to access what their taxes pay for. I'm not rich, but I can see there's an unfairness here. We all get sick, or old, and we all deserve healthcare; it's the least we all should get for the taxes we pay. A healthy population is a good thing. I don't want to be like the States where they are afraid they might 'pay' for someone else. I like to think in Canada we understand it's a collective and we take care of each other; all of us; because every one of us will need it ourselves one day. We all benefit then.
  • conrop12 about 1 month ago
    I can see a benefit for individuals having to pay a minimum amount for medications to avoid people taking too many unnecessary medications. Personally I have no coverage so if it comes to an expensive medication I just don't get it or try to find something over the counter that might work that is cheaper.
    Hide replies (9)
    • Dinah about 1 month ago
      Do you really think people take more medicines than their doctors recommend? And you are not doing yourself any favours not taking your prescribed drugs. I just hope you are not getting anything homeopathic, etc.
      • conrop12 about 1 month ago
        I never said people take more medications than their doctors prescribe but that could be possible. TV commercials constantly try to sell us products over the counter or prescribed to make us feel better. There is a well documented issue with prescription medication addiction. They estimate in the US it is 20% of the population. As for my personal situation I make informed decisions based on my budget and the seriousness of my situation. Being informed and using common sense is important. It helps asking the doctor what alternatives are available and has paid off for me.
        • keithmnop77 about 1 month ago
          "There is a well documented issue with prescription medication addiction." / It is a terrible problem for the addicted, but those drugs are not particularly expensive when bought legally. Very few medications are addictive, most prescription medications give you upset stomachs, mild diarrhea, mild nausea, mild headaches, occasional vomiting, which serve as their own incentives to not take them. / Making our own decisions based on what we read on the web and our assessment of the situation is actually why a lot of us men dies of heart attacks and strokes. / I have a chronic illness, and the medications for it are slowly killing me. I've got 5 to 10 years left. (I'm in my 60s anyways, so don't feel too sorry for me.) / One thing I've learned with my illness and the several hours of reading on medical topics I do each week is that being well read is not a replacement for a medical degree and clinical experience. / Even for MDs, they say "An MD who treats himself has a fool for a patient." / I'd add, "A patient who diagnoses himself for a doctor has a fool for a doctor." (I don't mean that personally, it is a failing many of us men have. I had it.)
          • Audrey 28 days ago
            Do you have any idea of the percentage of deaths due to medications every year? You better believe you need to pay attention to what you are prescribed.
        • Dinah 29 days ago
          Those commercials are on American channels. They are not actually allowed in Canada. Prescription medicine addiction is largely to a medicine that they may have had a prescription for, but now are obtaining illegally in most cases. Especially now that most of our doctors have woken up to the dangers of opioids.
          • Audrey 28 days ago
            A person can develop a resistance to many meds, e.g. for insomnia, depression, etc. Opioids is a tiny part of it.
            • Dinah 28 days ago
              You are quite right, and also antibiotics are overprescribed, especially for viruses, but we seem to be getting on top of that.
          • Mia 28 days ago
            Unfortunately, we have too much American content on our tvs Dinah
        • Mia 28 days ago
          Well then, it appears we really don't have all that much to worry about people being influenced by tv ads. Certainly not enough for that to be any reasoning for making people co-pay. And in the States you realize healthcare is just business; a commercial enterprise with consumers instead of health CARE ; hence the ads. Your argument is perhaps a reasoning for never privatizing any portion of healthcare, because it then becomes polluted by business interests.
  • Audrey 28 days ago
    It’s a good idea to share the cost. It reduces abuse.
    Hide reply (1)
    • Mia 28 days ago
      I actually don't think people who are sick abuse their medications much at all. Why are we so worried that someone might abuse it; how about we care more about sick people getting the medications they need.
  • Spinnaker175 about 1 month ago
    Making drugs completely free may foster unnecessary use of the medical system, and of the drugs themselves as a result, because there is no cost to the user. Imposing a limited percentage cost per prescription may cause people to think twice about the process. I would suggest a cap on the amount anyone would pay per prescription, and a means test to enable free drugs for anyone who simply cannot afford them.
    Hide replies (28)
    • will-o-the-west about 1 month ago
      I can't agree with that means test idea; it'd create a prohibitively expensive bureaucracy to manage it. Good point though, about needing some check to prevent unnecessary use.
      • Dinah about 1 month ago
        No means tests! No copayments! We have computer systems now folks! It ought to be quite simple to keep track of how much of any particular drug someone is picking up from all pharmacies in the province, if it goes against their health card number, as I have heard would be the case.
        • CGBe about 1 month ago
          All provinces use means-testing in some way now. It is not ideal, but it ensures equity - that those who need the most help get it. If there was no limit on resources, then we can give everyone everything, or everyone the same. The former is too expensive, and the latter encourages a race to the bottom, e.g., an essential drug list with 125 products, but not the ones most people need help affording.
          • keithmnop77 about 1 month ago
            Canadian taxpayers pay for pharmacare now. It currently exists. The problem is that most taxpayers aren't MPs, civil servants, military, or first nations. I don't want to perpetuate the current situation where people are paying for something they cannot collect.
            • CGBe about 1 month ago
              I don't understand. Are you talking about federal drug programs (employees/retirees, military, RCMP, First Nations, Corrections, refugees)? Sure those exist, mostly as a complement to provincial programs. The employee/retiree plan is just like those offered by other public and private sector employers. Yes, they're all paid for through general taxation. As for something I pay for that I can no longer use...My kids are finished with the public school system, but I still have to pay education taxes...which is fine by me. That's equitable, I can afford it, and it's a duty of citizenship.
              • Dinah 29 days ago
                Then you and the rest of us can probably afford pharmacare and look at it as a duty of citizenship.
          • keithmnop77 about 1 month ago
            National pharmacare should be paid for by a form of progressive taxation -- those making more money pay more, those with more wealth pay more. / Since it will be paid for by progressive taxation there is no reason to have a second round of redundant pointless income adjustment of a means test.
            • CGBe about 1 month ago
              The health system is generally paid that way now of course. But general taxation doesn't account for the moral hazard risk - using more health services or drugs because the cost is subsidized by another party. That's where some reasonable level of cost-sharing can work to dampen demand, and share the costs. (All EU countries have patient cost-sharing although in different amounts for different services, and often for hospital and MD access.) The key is finding the level that makes people sensitive to the cost, but does not deter access for those who need the drug or health service.
              • Mia about 1 month ago
                I think the fact that doctors prescribe the drugs as needed takes care of that issue.
                • CGBe about 1 month ago
                  But the evidence is that prescribers don't always do a good job, and it's not just on them. (I posted some Cdn studies a few minutes ago.) The opioid issue is a good example of all the places the system can fall down. This was a highly addictive product that was aggressively marketed, often inappropriately prescribed by physicians and monitored by pharmacists, and not effectively regulated by Health Canada. I think the days where we can simply trust everything to work without collecting appropriate data and reporting are long gone. That's also a plug for investing in systems and administration that can properly monitor $34 billion of spending and know we're getting good value for our money.
                  • Audrey 28 days ago
                    Yes a computer could catch errors and deliver product better than any pharmacist
                  • Mia 28 days ago
                    Data collecting ? Really? Why all the concern about how doctor's prescribe; that's a different issue and not a reason to make people pay or deny universal pharmacare. Take it up with the pharmaceutical companies who fund university medical programs and then buy their way into dictating doctor's programs ( emphasis on prescribing their drugs of course). Maybe we should demand that pharmaceutical companies are not allowed to dictate doctor training. That would address your concern far more accurately than as an issue to justify limiting coverage by universal pharmacare.
              • Dinah 29 days ago
                It's interesting. In Britain, they took off the copays for drugs at one point and then reinstated them years later for austerity reasons. It would be interesting to see if that was studied and what happened in the 2 different periods. I believe that they now pay 10 pounds per prescription and lots of people complain that that is unaffordable. And how do the admin costs work out? I'm not aware that they pay to see an MD or go to hospital. Please give examples of the countries you speak of, so we can check out what you are saying.
                • CGBe 29 days ago
                  Have a look at this recent publication from the Commonwealth Fund, specifically the Appendix on p. 13: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2017_oct_sarnak_paying_for_rx_ib_v2.pdf. Drug costs for ten countries are included. There are four NHS bodies in the UK. Three provide drugs at zero patient cost. England requires an 8.60 pound co-pay per drug, with various subsidies and exemptions according to income and disease. The UK and Canada are very similar Beveridge models, but most EU systems are social insurance models. They include a much broader set of insured services including drugs, dental and often long-term care. There is a system level deductible, either flat or income-based. Funding comes from employers, citizens and government, in that order, also different than in Canada. There is no perfect system - we can learn from all of them.
                  • Dinah 28 days ago
                    Thank you for the link. Yes, I do remember now reading that the deductible only applies in England (the Celtic areas are more pragmatic as a rule!). Some of the other graphs in there quite interesting as well.We should set about learning about these other systems. I will volunteer if the Pharmacare committee wants to send me to Europe!
            • Audrey 28 days ago
              Your tax return doesn’t necessarily reflect your current “ability to pay”. Nor does your credit score.
              • Dinah 28 days ago
                This is why we don't want co-pays, etc. And your income on your tax return is not relevant at the time of accessing a drug. Your tax return shows what you made over the course of a whole year, and your tax, including that to cover Pharmacare, is based one that.
              • Mia 28 days ago
                Good point
          • keithmnop77 about 1 month ago
            The USA uses a means test now too, in its eligibility for Medicaid. The problem is they exclude the middle class and working poor from benefits.
            • Mia 28 days ago
              For one do not want to look at anything the USA does related to healthcare. They are a disaster.
          • Lise King 29 days ago
            When people are ill they sometimes do need more then essential drugs... that is when many people are in trouble... and some die for lack of access... So please make sure to think of this issue when drafting a bill... If need they need to be able to receive appropriate affordable care...
            • Mia 28 days ago
              Yes. I think it should be drugs that are prescribed are covered. Period. If anyone is concerned about how doctors prescribe; that's a different issue to look at.
        • keithmnop77 about 1 month ago
          Dinah, when I worked I worked in IT. Computer systems cost huge amounts to write and while they do reduce the cost of paper work they do not eliminate it. Co-pays and deductibles will probably mean IBM, EDS, etc.charge us $25 billion up-front (I'm rounding), delay implementation of pharmacare for 12 years, and cost $250 million a year in IT maintenance fees, and $500 million a year in IT operating costs. // And then the cost of accountants, bookkeepers, auditors, managers, and trainers will be on top of that.
          • CGBe about 1 month ago
            You're assuming the federal government has to run this. I think it's more likely the provinces will administer it using their existing systems, so the costs are transactional and maintenance. No one needs another Phoenix!
          • Dinah 29 days ago
            You do make a good point. The e-health disaster in Ontario is another one. I worked in genetic testing and you wouldn't believe the number times repeat testing was ordered just because the individual now had another doctor. (With inheritable disease genetic tests you only need one lifetime test, as you either inherited a problem in a gene or you didn't, and that's not going to change.) With e-health, that test result should have been immediately available to the new doctor, but it's still not up and working.
    • Mia about 1 month ago
      More bureaucracy makes it all onerously expensive. How about we trust doctors to prescribe what is needed to who needs it.
    • Audrey 28 days ago
      There are poor people and homeless who must be allowed access.
      • Mia 28 days ago
        EVERYONE should be covered. All Canadian citizens.
  • Mofrob 28 days ago
    Remember the topic is a prescription drug plan. Over use and drug abuse is NOT the topic. Our health care system is incomplete. There is more than enough money available when our tax system is corrected. Our Old Age Pension system is a good example to follow; excess is clawed back after income reaches a certain level. Otherwise drugs should be “free” to anyone who needs them and the best drug for the job - not the cheapest.
  • DRED 28 days ago
    I suspect that compliance will improve with individuals paying a portion due to ownership and an understanding of the costs of care. (In ON in the 70s we used to occasionally get a report of the cost of hospital procedures for our children which gave us a deep appreciation of the costs of care). In NS today, as seniors, we pay a portion of prescriptions within the provincial program.On the flip side, it may exclude some people from access. Some sort of formula to index with income might be necessary to minimize exclusions. This could be the beginning of a complexity that will be fraught with problems.In concert with a national pharmacare plan, there needs to be continued work on wellness ... creating less demand on the system through doing things that influence societal wellness.
  • SustainabilityFirst 28 days ago
    The primary benefit of individuals sharing the responsibility of payment is to enhance the sustainability of the program. A cost-sharing element that is indexed to income can ensure that those that have the ability to pay do so while providing for those that are less fortunate. Secondarily, payment can introduce a level of accountability to the users of the program.
  • Tamayaka about 1 month ago
    Benefits: 1) Patients aware of the cost of products can increase appreciation for them - I think patients being aware of cost of services is also good, e.g. 20 years ago it was $300 for the expertise of an MD for 30 seconds to check if my baby had a concussion after I fell. I was shocked. I had no idea it was so expensive. 2) Co-payments through insurance companies, unions etc. provide a systemic resistance to the drive in the pharmaceutical industry to secure the greatest profits possible via strategies such as price hikes and new (expensive) patents. 3) Govt programs currently in place to assist those who require financial assistance already provide access to a specific list of medicines. This service can be expanded if additional income brackets will be included. 4) Keeping the patient as the client rather than the government may protect our country from being sued through trade agreements, e.g. NAFTA, Clause 11. Drawbacks: Maybe keeping co-payments would nix savings that could be made by removing multiple payment streams, but creating/maintaining patient cost awareness and resistance to pharmaceutical price gouging could well be worth it.
    Hide replies (3)
    • Mia about 1 month ago
      Where did you get the figure $300 for 30 seconds? You would not have gotten a bill. That is very incorrect. Maybe in the US. Here in Canada; no; my cousin is a doctor; that is not at all correct. Maybe you are including tests? X-rays? Very curious that figure.
      • Tamayaka 29 days ago
        I saw my chart at the nurses station and was surprised to see a dollar figure on it. I was in a Canadian hospital.
        • Mia 28 days ago
          How very strange. I just showed this to my friend who is a nurse at the hospital here. She said she's never seen such a thing. She said that's not how billing works. She said it is very odd that anything related to billing would be on any patient's chart, as the patient's chart 's purpose has nothing to do with billing.
  • CGBe about 1 month ago
    There are three benefits: (1) Patients are aware of the cost of the drug and appreciate the value of the insurance subsidy. (2) Appropriately designed and moderate cost-sharing mitigates the risk of moral hazard. (3) Patient contributions can materially reduce the total cost that must be paid by governments or employers. The main drawback is that those in the poorest health are often least able to afford drugs. The way to address this is through universal coverage and effective, progressive income-based subsidies targeted to ensure no one goes without a drug due to cost. A second drawback occurs if governments have high deductibles that must be satisfied before the patient receives reimbursement. This can be mitigated by designing a plan without a deductible or ensuring the deductible can be satisfied over a period of several months.A final comment is that we now have an opportunity to treat all Canadians the same, so that adequate coverage no longer depends on where you live or work.
    Hide replies (6)
    • Dinah about 1 month ago
      Patient contributions would probably not even add up to the cost of collecting them.
      • CGBe about 1 month ago
        With almost 700 million prescriptions filled every year in Canada, I disagree! But of course it depends on how much is collected per script. Systems are so completely automated that transaction costs are very small. Almost everyone who has drug coverage now pays a share, and almost everyone does so without financial hardship. As I said, let's subsidize those who need help and cap out-of-pocket payments. Many other countries with better health outcomes and lower costs include some level of patient cost-sharing, which also helps explain why their public health systems are far broader than ours.
        • keithmnop77 about 1 month ago
          Say you do $10 per prescription co-pay. I worked in IT. I'm retired, so I may be a little out-of-date, but I doubt the cost of the $10 will even cover the work the pharmacy does to collect it, let alone the cost of the government employees to collect it, the cost of the government IT system to administer it. Having co-pays and deductibles will delay pharmacare by 10 maybe 12 years.
          • CGBe about 1 month ago
            I don't understand the connection between having some level of cost-sharing and a delay in pharmacare. Almost everyone now has some kind of cost-sharing and it serves to reduce the total cost of governments or employers. Every dollar is already distributed to pay the pharmacy, the drug manufacturer, the distributor, and whoever administers the drug plan. So what would be different in a new model with no cost-sharing, other than higher cost to governments and employers?
        • Dinah 29 days ago
          Can you give us the names of those countries so we can check on that?
  • Marnie about 1 month ago
    I am for individuals paying a portion of the costs of their prescription drugs, according to their abilities to pay. I am unemployed, financially challenged, under 65, and without help for medical, dental, optometry, podiatry, … Thus, I mostly have to do without.We cannot afford to cover everything for everyone; that is a simple fact.What I would like to see is that the government and other organizations should stop having programs that say:if your income is below x, then you will be covered one hundred percent (100%) for whatever it is that the program covers andif your income is x or above x, then you will be covered zero percent (0%) for whatever it is that the program covers.Thus, because my income is, say, one dollar ($1.00) more than someone else's, I get zero percent (0%) of whatever it is that the program covers while that someone else gets one hundred percent (100%) of whatever it is that the program covers. That is not right or fair.Government programs should use tables similar to child support tables.This would not have to cost the government (much) more money; it would simply distribute the money more fairly.For example, let's say that x is one hundred dollars ($100.00).So, if your income is below one hundred dollars ($100.00), then you will get one hundred percent (100%) of whatever it is that the program offers andif your income is one hundred dollars ($100.00) or above one hundred dollars ($100.00), then you will get zero percent (0%) of whatever it is that the program offers.Let's say that the total money to be distributed is one hundred dollars ($100.00).Let's say that this money is currently being distributed as follows:$10.00 (100%) each to ten (10) people, with the incomes of those ten (10) people being:- zero dollars ($0.00),- ten dollars ($10.00),- twenty dollars ($20.00),- thirty dollars ($30.00),- forty dollars($40.00),- fifty dollars ($50.00),- sixty dollars ($60.00),- seventy dollars ($70.00),- eighty dollars ($80.00), and- ninety dollars ($90.00).By instead using tables similar to child support tables, the distribution of the one hundred dollars ($100.00) could be something like the following:- $10.00 (100%) to the person whose income is zero dollars ($0.00);- $9.50 (95%) to the person whose income is ten dollars ($10.00);- $9.00 (90%) to the person whose income is twenty dollars ($20.00);- $8.50 (85%) to the person whose income is thirty dollars ($3.00);- $8.00 (80%) to the person whose income is forty dollars ($40.00);- $7.50 (75%) to the person whose income is fifty dollars ($50.00);- $7.00 ($70%) to the person whose income is sixty dollars ($60.00);- $6.50 (65%) to the person whose income is seventy dollars ($70.00);- $6.00 (60%) to the person whose income is eighty dollars ($80.00);- $5.50 (55%) to the person whose income is ninety dollars ($90.00);- $5.00 (50%) to the person whose income is one hundred dollars ($100.00);- $4.50 (45%) to the person whose income is one hundred ten dollars ($110.00);- $4.00 (40%) to the person whose income is one hundred twenty dollars ($120.00);- $3.50 (35%) to the person whose income is one hundred thirty dollars ($130.00);- $3.00 (30%) to the person whose income is one hundred forty dollars ($140.00);- $2.50 ($2.50) to the person whose income is one hundred fifty dollars ($150.00);- $2.00 (20%) to the person whose income is one hundred sixty dollars ($160.00);- $1.50 (15%) to the person whose income is one hundred seventy dollars ($170.00);- $1.00 (10%) to the person whose income is one hundred eighty dollars ($180.00);- $0.50 (5%) to the person whose income is one hundred ninety dollars ($190.00); and- $0.00 (0%) to those whose incomes are greater than or equal to two hundred dollars ($200.00).This example would cost the government $105.00 instead of the current $100.00.And, if you really wanted to keep it to the current $100.00,then simply make it zero percent (0%) for those whose incomes are greater than or equal to one hundred sixty dollars ($160.00)instead of greater than or equal to two hundred dollars ($200.00).Using tables similar to child support tables not only helps more people but also helps people more fairly than what the government is typically doing right now.
    Hide replies (2)
    • keithmnop77 about 1 month ago
      I am in much the same situation as you. But we can afford to cover everyone. And the reason we can afford to cover everyone is we will be replacing the cost of private and group drug coverage with public coverage. No new costs, in fact likely savings since: / 1. National pharmacare without deductibles or co-pays won't need complicated accounting. / 2. National pharmacare will be able to negotiate lower drug prices. / National pharmacare (realistically, provincially run pharmacare that meets federal minimums) will cost no more than what we collectively pay for group insurance and out-of-pocket now. / The only reason to not make group insurance obsolete is to maintain the value of the group insurance and employment benefits firms. (The finance minister's old family employee firm was an employee benefits firm. But apparently he has divested his ownership and interest in it.) /' The wealthy will be paying for our pharmacare. The least we can do is let them pay for their own pharmacare as well.
    • Dinah 29 days ago
      I agree that the arbitrary cutoffs the governments use are stupid. Not only in drug coverage, but support payments of all kinds. They actually disincentivize people from working because they would be cut off their benefits. But forget the tables--we have computers now! It could be a completely sliding scale. That is, if I agreed with any kind of copay or deductible, which I don't. You have typed so much and it just illustrates how bureaucratic it would be!
  • thornburyone 29 days ago
    Benefits: drug cost shared between program and patient who needs the medication.Drawbacks: Low income patients may not be able to afford necessary medication
    Hide replies (2)
    • Lise King 29 days ago
      I agree... When you are ill the income reduction is drastic which causes financial difficulties as it is, it may mean the difference btw necessities in life or medication... We all got to eat, we all need home heating and hydro...
    • CGBe 29 days ago
      The biggest gap in coverage, research suggests, is among those who work but have low incomes. All provinces currently have subsidies and exemptions for low income residents, but the rules are all over the place...literally. Sometimes you have to be on social assistance to get access to the provincial plan, but seniors usually get good coverage regardless of their incomes. Not everywhere though. Provinces now set these thresholds based on budgets, policy and politics. The federal government has money to spend to improve fairness. I identify as Canadian first, and then a resident of my province. So I want Canadians to be treated the same, not worry about drug cost, and know the system is fair.
  • Cats Corner 30 days ago
    The biggest issue is if it is based on income. Currently in MB, to be eligible for the pharmacare plan, based on my income-I have to spend $6000.00 first to eligible. My insurance only covers up to $2000.00 per yr. I currently live pay check to pay check, and have little $ left over. Many middle class Canadians are caught between a rock and a hard place. It is no different than low income Canadians, we all have difficulty paying for health benefits when we have so much else to pay. I am a healthcare provider who cannot afford my own medications. I feel like such a hypocrite as I advise my clients to take their meds as prescribed, yet I can't follow my own recommendations as I maxed out my drug plan and can't afford the huge pharmacare deductible that
    Hide replies (2)
    • Lise King 29 days ago
      That is the same with private healthcare... They put a cap on it and the drugs i myself cost more then the cap... I rather pay more for a public healthcare with cut out private healthcare all together... What we pay them if all collected in one public will help when we need it... and regulate the cost of pharmaceutical drugs don't let them inflate the cost because there is no cap on the drug companies...
    • CGBe 29 days ago
      Since the question is around cost-sharing, then you're right on point. Unless there's better equity/fairness then Canadians are not being well-served by our governments. Provinces like BC, SK and MB have income-based plans targeted at catastrophic expenses. But the definition is different in every province. Paying $6K out of pocket is probably OK if you make $200K. In NS, cost-sharing can run as high as 35% of family income before the provincial plan helps. In SK, it's 3.4% flat, for all incomes. Cost-sharing should be identical and at reasonable levels across Canada. Same with the threshold above which provincial plans step in to cover 100% of the cost. The federal role, I think, is to set the standards and then fund each province to meet those standards. And private drug plans, assuming they continue, should run with the same rules...meet a national standard design and ensure that private plan members have similar benefits to those covered by provincial or federal plans.
  • let's talk health 30 days ago
    everyone above a certain income should pay a percentage which will help with plan costs, stop wastage and increase competition.
  • zinger526 about 1 month ago
    im going to put my two cents worth in here, me and my wife are retired I have private health insurance, my wife has type two diabetes she take two different insulins plus metformin and six other drugs I take two, we are both over 65 and retired and anyone whos retired and paying private health insurance premiums knows its not cheap, I have a premium plan and paying 300.00 a month which includes dental and making these payments is not a easy task , its like having a small mortgage payment, to make this short I have nothing against paying a small monthly fee which should be figured out on a tier system dependent on age and income also it would be nice to see a plan to include dental at a nominal premium, also dependent on age and income or hears another scenario raise the gst or raise the personal income tax rates I personally like the first scenario better its more realistic and probably will be the outcome of pharma care if its ever implemented that is .
  • Sickboy about 1 month ago
    We currently track everything that is spent on people, test drugs etc but no one is aware of these costs per individual. By providing that we would identify the highest users of the system and start the health interventions to improve the situation. As I said before, if you choose to smoke, drink and not exercise but continue to cost the system with high drug costs and visits to doctors and hospitals, put in a plan to fix it on an individual basis. Doctor should take responsibility with a team of pharmacist etc to improve the outcome and get paid for that. Currently the system rewards health professionals for the sickest patients by more prescriptions and more fee for service visits. No incentive to fix anyone, much like a chiropractor
  • keithmnop77 about 1 month ago
    Having co-pays and deductibles will delay pharmacare by 10 maybe 12 years. The governments would have to hire IT consulting firms and we'd have a repeat Phoenix Payroll fiasco. Big government IT projects take huge amounts of time and the consulting firms they hire make billions. We should only have co-pays and deductibles if there is a very clear cut objective case for them that does not involve class-oriented revenge. Pay for it with a progressive means of taxation, no deductibles, no co-pays, implement it in 3 years. Or make it needlessly complicated, outrageously expensive, and don't have Pharmace until after 2028. // And the Phoenix Payroll fiasco is only one of dozens of multi-billion dollar IT fiascos from government paid, big contractor run IT projects around the world. / The only thing unique about Phoenix Payroll was that the prime contractor got the client to testify before a parliamentary committee that (essentially) it was the client's fault the consultant did an incomplete analysis and started constructing a system that did the wrong thing.
  • Old Guy about 1 month ago
    Main drawback is that we will still have people who cannot afford the medications they require. I see no benefit to this.
  • dlhealth about 1 month ago
    Unless such a system was based on income (i.e. ability to pay) it could not be universal. And it seems to me that regulating that would be both complex and expensive. Far better, I think, to simply include a set percentage in our income taxes so that those who can afford it pay more.
    Hide replies (2)
    • leslea_kate about 1 month ago
      Such as the rich paying their fair share in taxes, and not being permitted to hide it in offshore tax shelters? That's an idea I can definitely appreciate!
    • Mia about 1 month ago
      dlhealth: Concerned about how we "find the money" to fund universal pharmacare ? Here's your answer. A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask?
  • hutchb about 1 month ago
    I see no benefits to co-payments or deductibles. People whose finances are tight will fail to fill prescriptions or forego other necessities (such as food, shelter, clothing) if they face co-payments or deductibles. Premiums entail substantial administrative costs; better to finance pharmacare from general tax revenue.
    Hide replies (3)
    • Dinah about 1 month ago
      And let's not forget that food, shelter and clothing are part of the social determinants of health. People who cannot afford these will actually need more medicines in their futures!
    • CGBe about 1 month ago
      We need to consider something other than one-size solutions and generalities. For people in financial need, there are subsidies now in public drug plans, and those should continue...but be equalized across Canada, and lowered in several provinces where they are too high to properly protect people from catastrophic drug costs. Tax revenue is the most efficient way to finance health care, but just as we have consumption (sales) taxes, it is reasonable for patients to pay for part of their costs as they can afford. Also agree with Dinah - social determinants are more important (at a population level anyway) and should be considered in our health system but typically are not because they cut across Ministries and their budgets.
    • Mia about 1 month ago
      Concerned about how we "find the money" to fund universal pharmacare ? Here's your answer. A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask?
  • Sunny_58 about 1 month ago
    The drawback would be that the working poor (lower and lower-middle-class individuals and families) who already have tight budgets would probably not be able to afford the cost of prescriptions, even if it was only a portion. The people I know in this situation would not be able to afford it, and that would have included me two years ago before I acquired a second job. It is somewhat punitive to ask them to pay anything at all considering how they struggle. Depending on how the payment system is implemented, I think that for people with health conditions or disabilities, having to pay a portion of their drug costs would also be a significant disadvantage. These people already often face barriers to employment and have high costs for essential medical equipment, physical therapies, and modifying their homes for more accessibility. Sometimes they have to hire personal assistants or nurses for daily tasks. Putting one more cost on these people's backs would be truly terrible.
  • keithmnop77 about 1 month ago
    The benefits of annual deductibles are that: / 1. They spread the cost out between the employer and the employee.(Not applicable to government pharmacare since taxpayers are paying one way or another.) / 2. They create jobs for claims examiners and accountants. // The downside of annual deductibles for government run pharmacare are that: / 1. They place the greatest burden on the sickest employees. / 2. They create considerable overhead costs without bringing any benefit. // Ideally, the government should cut overhead costs and simply have no annual deductible. / If the government wants to preserve jobs and continue overhead costs and continue private insurance, then universal pharmacare for all should be catastrophic coverage, say kicking in when claims reach $1,000 per person. ($0 for those with reported annual incomes less than $15,000 per year.)// Since the wealthy would be paying for our pharmacare plus their own, it makes no sense to go to the expense of a means test or income adjusted deductible. / The wealthy are paying for us as well as them, the least we can do in return is give them the same coverage they are giving us.
  • keithmnop77 about 1 month ago
    The benefits of per-prescription co-pay (deductibles) are that: / 1. They spread the cost out between the employer and the employee.(Not applicable to government pharmacare since taxpayers are paying one way or another.) / 2. They create jobs for claims examiners and accountants. // The downside of per-prescription co-pay (deductibles) for government run pharmacare are that: / 1. They place the greatest burden on the sickest employees. / 2. They create considerable overhead costs without bringing any benefit. // Since the wealthy would be paying for our pharmacare plus their own, it makes no sense to go to the expense of a means test or income adjusted co-pay. / The wealthy are paying for us as well as them, the least we can do in return is give them the same coverage they are giving us.
  • leslea_kate about 1 month ago
    Benefits? It's health care & having to pay for it goes against the very notion of truly universal healthcare. It only benefits the bottom line of pharma giants to line their pocketbooks. Get rid of the co-pay BS, as that's a HUGE reason that people go without medications. NO more co-pay, NO more deductibles and NO more premiums. ONE payer only. ONE. ALL pharma costs need to be done through a single payer, which is the only proven way to cut the costs once and for all. There are no benefits long term for the people paying directly. Because eventually politicians pollute the discourse as well and they try to cut off those they don't approve of in order to "cut costs". Only with this, it can kill those who get clipped from the system. Make it politician proof. EVERYONE gets covered for everything their doctor deems a need. Anything less will fail. Personally I had a major health event last December, and as a result had to go on a large number of medications. I'm on AISH (Assured Income for Severely Handicapped, the Alberta disability program), and thankfully I do have (at least while on the program) my prescriptions covered. Even so, I tallied up the extra medications & if I had to pay for them, it would be well over $500/month. As someone who is disabled and on a very restricted income, without that pharma coverage, I'd either lose my house, or I'd die. Those are literally the choices when the costs are this severe. One of the medications is close to $250/month. Another is $150. These are medications that my cardiologist deemed essential to keep me alive. My choice is take them or die. Damn right we need full pharmacare. Because I'm not the only person that's on these kind of medications and expecting people to pay or die, is not a reasonable way to make people live. It's extortion by any other name.
  • Mia about 1 month ago
    I have a private extended health care plan that I pay for for both myself and my spouse in retirement. The cost of this takes a big chunk out of a quite meagre monthly income. 3 years retired now, and 3 years of paying to this company every month, but we still have had nothing covered under this plan because the deductible is so high. $400 a month each is the deductible AFTER the senior $200 a month deductible for the Ontario senior healthcare plan. So we need to buy $600 worth of drugs each before this private plan pays anything at all; and then, only 70%. I would much rather pay the government and get covered without these ridiculous deductibles. We have a limited income; hence we are also afraid not to have coverage IN CASE of significant illness that requires costly drugs etc.
  • Veteran educator about 1 month ago
    Drawback is that partial payment adds a layer of useless bureaucracy.
  • sillverwillow about 1 month ago
    Universal drug coverage should be available to all. We don't pay to see a doctor or have an xray. We should not have to pay for the cure of what the diagnosis is.Savings can be gained if medication costs the same in every province. Make deals with drug companies and achieve savings that way. a mean test is discriminatory and would be costly to administer. Copay or deductibles also cost money to administer.