September 1, 2015
Originally published in The Hamilton Spectator
During my 30 years as a family physician practicing in downtown Hamilton, many of my patients struggled with the cost of prescription drugs. I frequently found myself begging drug company representatives for "samples" to give to patients with inadequate or no drug coverage.
Canadians spend more on prescription drugs than any of the 33 member countries of the Organization for Economic Cooperation and Development (OECD), except the United States. We're the only country with a universal health-care system that doesn't cover medications. In a recent Angus Reid Institute poll, one in four Canadians (23%) reported that in the last year they or someone in their household did not take their medication as prescribed because of cost. The numbers are higher for younger adults, lower income Canadians and those with no or limited drug coverage. An overwhelming majority (88%) agree that "Every Canadian — regardless of income — should have access to necessary prescription medication".
More than 100 health policy experts and health-care leaders from across the country have endorsed the Pharmacare 2020 campaign recommendations for a universal, single-payer, publicly accountable pharmacare program. And earlier this month, Hamilton City Council passed a motion calling on the provincial, territorial and federal governments to implement a universal pharmacare program. So what are we waiting for?
The usual argument against universal pharmacare is that we can't afford it. However, according to a recent study in the Canadian Medical Association Journal, a universal public drug plan, one facilitated by the federal government and run by the provinces, would be cost saving. Such a plan could provide coverage for all Canadians, ensuring access to the prescription drugs they need, while saving Canadians $7.3 billion a year — a 32% reduction in total drug expenditures. Individuals and businesses would save $8.2 billion while government expenditures would increase by $1 billion, which is considerably less than 1% of current government expenditures on health care. The cost to governments could be even less because these figures don't account for the potential savings from reduced use of publicly-funded hospital and physician services resulting from improved access to safe, effective and appropriate medications. Let's stop for a minute and imagine: a social program that improves health and saves Canadians several times the added cost to the public purse. What's not to like?
A national pharmacare plan would yield substantial benefits for municipalities such as Hamilton. Approximately two-thirds of municipal employees in Canada, including those in Hamilton, receive supplemental health care insurance through their employer. In Hamilton, prescription drug coverage represents over half the cost of employee health benefits. Cities across Canada spend over $500 million each year on drug plans. Imagine what it would mean to have that money available for other municipal priorities. Council's recent support of a national pharmacare plan clearly makes good economic sense.
Hamilton has joined other cities across the country in its call for a national pharmacare plan. Organizations and individuals are adding their voices through the Campaign for National Drug Coverage (www.campaign4nationaldrugcoverage). It's time to add prescription drugs to Canadian Medicare.
Dr. Brian Hutchison, Professor Emeritus of Family Medicine and Clinical Epidemiology and Biostatistics at McMaster University, is a retired family physician and is on the board of directors of Canadian Doctors for Medicare.