National Pharmacare for Everyone in Canada
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2018/06/02
Professor Gordon Guyatt, MD, MSc, FRCP, OC is a Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact and Medicine at McMaster University. He is a Fellow of the Canadian Academy of Health Sciences.
Here we talk about the potentials for a national pharmacare program.
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Professor Guyatt and I talked about the dynamics between the medicare and pharmacare systems for Canada. The important point, the former exists; the latter does not exist. Why? “Historical accident,” Guyatt said.
The national healthcare program never expanded to a national pharmacare program out of historical accident. Most developed nations have one. It drastically lowers the price for most people, so benefits more of the population.
Other nations of the developed world considered this to a greater extent. The Canadian Finance Minister Bill Morneau not too long ago talked about the formation of a committee and then the development of a national healthcare program in Canada.
At the time of the interview, Guyatt, though things may have changed, stated, “The status of that is, at the moment, unfortunate. So, Eric Hoskins resigned as health minister in Ontario to go and work on this. We thought – it is hard to know – that he was quite progressive. That he would be doing this because it is very exciting to have a real national pharmacare.
Bill Morneau (at the time of the interview) talked about the possibility of a mixed public-private healthcare system akin to the system developed by the Obama Administration prior to the Trump Administration in the United States.
“If it happens that way, it will be extremely unfortunate. Whereas, people who are interested in national pharmacare got very excited about the apparent initiative. The way Morneau has talked about it, subsequently, has considerably dampened the enthusiasm and gotten people much more worried,” Guyatt laments.
For the lower socioeconomic status or SES Canadians, the prices can be big issues. These are people with part-time jobs, poorly paying jobs, and low-skill jobs. This lead some of the conversation into the health gap between Indigenous and non-Indigenous Canadians.
It is about 10-15 years, depending on reportage, in lifespan not to mention healthspan between Indigenous Canadians, as Professor Guyatt has likely read and knew. It is a national concern. According to a colleague Professor Guyatt talked with, apparently, some Indigenous have drug coverage. That spares some the problem.
Other folks, the lower-income Canadians in general, will have a real problem; the ones without drug coverage have a real problem on their hands. When I asked for numbers on the problem, Guyatt stated, “I have seen different statistics. I think it would be of the order of 15% or 20% who, when asked, would say, ‘I haven’t filled a prescription because of the financial issues.’”
Some activism became part of the conversation as well. Guyatt described how letters to the fedral MPs can be a great help. Those letters with group signatures for pharmacare. Guyatt opined, “I think the politicians are more impressed at individual letters, individually written. Anyone who cares about pharmacare and who would like to write an, even brief, individual letter. Those things make a difference.”
The things most appealing, likely, to the poorer Canadians would be the coverage for everyone under 25 in Ontario by Kathleen Wynne, according to Guyatt.
“So, people on social assistance over 65 get coverage. Now, she has extended it to everyone under 25. Here is pharmacare for everyone under 25,” Guyatt explained, “Now, it is a relatively easy population because people under 25 don’t usually need many drugs. So, it is good. It is nice. But a relatively inexpensive group to extend to. In terms of what is required to gain both the equity and the efficiency goals, it is a program that would simply give universal coverage. The way we have for physicians in hospitals.”
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The British Medical Journal or BMJ had a list of 117 nominees in 2010 for the Lifetime Achievement Award. Guyatt was short-listed and came in second-place in the end. He earned the title of an Officer of the Order of Canada based on contributions from evidence-based medicine and its teaching.
He was elected a Fellow of the Royal Society of Canada in 2012 and a Member of the Canadian Medical Hall of Fame in 2015. He lectured on public vs. private healthcare funding in March of 2017, which seemed like a valuable conversation to publish in order to have this in the internet’s digital repository with one of Canada’s foremost academics.
For those with an interest in standardized metrics or academic rankings, he is the 14th most cited academic in the world in terms of H-Index at 222 and has a total citation count of more than 200,000. That is, he has the highest H-Index, likely, of any Canadian academic living or dead.
He talks here with Scott Douglas Jacobsen who founded In-Sight Publishing and In-Sight: Independent Interview-Based Journal. We conducted an extensive interview before: here, here, here, here, here, and here. We have other interviews in Canadian Atheist (here and here), Canadian Students for Sensible Drug Policy, Humanist Voices, and The Good Men Project (here, here, here, and here).
License
In-Sight Publishing by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Based on a work at www.in-sightpublishing.com.
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