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Free healthcare isn’t free

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Here in Canada, a core part of our national identity (some might say the only part) is being better than the United States, and our go-to example when comparing our two nations is “we have universal healthcare and you don’t, so there!” Sadly, this claim is not strictly true.

It is true that Canada has free healthcare, in that we are not made to pay for consultations, surgery, or hospital stays. However, there is one glaring omission in Canada’s “universal” healthcare system: prescription drugs. In Canada, patients must pay for any prescription drugs that they require out of their own pocket, but some people’s pockets are deeper than others.

According to a Statistics Canada survey reported by the CBC, nearly one million Canadians were forced to sacrifice spending on food, heat, and other essentials in order to afford the medication they needed. An even larger number, some 1.6 million people, 8.2 per cent of all people prescribed medication in a year, were forced to go the other way, splitting pills, skipping doses, and refilling prescriptions less frequently, because they could not afford both medicine and essentials.

When our citizens are forced to make agonizing choices like these, it really defeats the purpose of having universal healthcare. It also puts unnecessary strain on the healthcare system due to medical conditions being allowed to worsen, eventually resulting in the need for hospitalization, and radical treatments. Any money we’d save might be offset by the additional funds spent on intensive care; to say nothing of the human cost, which can result in avoidable disfigurement, permanent disability, or even death.

This state of affairs is not normal. Canada is the only country in the world that has universal healthcare, but does not have universal drug coverage. Canadians pay more for prescription drugs than any other nation, except the United States. We pay up to 1,200 per cent more per year for the same drugs manufactured by the same companies than New Zealanders pay, according to the CBC. The sad truth is that we are a lot closer to the United States in terms of medical policy than we would care to admit.

The main reason for this appears to be that pharmaceutical companies often advertise directly to doctors. A hidden camera exposé by The Fifth Estate revealed that drug companies frequently downplay or neglect to mention flaws and side effects of their products, as well as touting bonus effects of dubious veracity. More to the point, these companies often recommend their expensive products, even when cheaper alternatives exist, and doctors will often prescribe them by default, even though official guidelines recommend that the cheapest options should be tried first, and more expensive drugs used if the first ones prove ineffective.

I can understand why doctors may not exercise due diligence, because they are very busy (if not downright overworked) people even without having to analyze and make informed decisions about the medicines they use. It is so much quicker and easier to take Big Pharma’s word for it, especially if they sweeten the pot somehow. Some experts have recommended that a government panel be established for the purpose of testing and reviewing the products of pharmaceutical companies, and then passing on their findings and recommendations to the doctors. Personally, I think this would be the best way to go. Until, and even after, such a body is formed, I would ask that medical practitioners exercise more due diligence in selecting appropriate treatments for their patients, including (and I can’t stress this enough) more of a two-way dialogue that takes the patient’s needs, resources, and individual biological responses into account.

Our government, not content to merely be second worst, is already taking steps to rectify this situation. At the provincial level, B.C.’s Minister of Health, Adrian Dix, has announced a new regulation that will eliminate PharmaCare tax deductibles for those who make less than $30,000 per year, or are over the age of 79, and reduce them for those who make between $30,000 and $45,000 per year.

The new regulations go into effect January 1, 2019, so a hard year remains ahead for those struggling to pay for medicine, but still, better late than never. At the federal level, Health Minister Jane Philpott has promised to help Canadians save “billions” on healthcare costs by renegotiating price levels with drug companies to bring them more in line with similar developed nations like New Zealand.

For too long, we Canadians have sat on a high horse, and gloated over our superiority to our southern neighbours without really looking around to see if we stack up as well compared to anyone else. While there may or may not be a prize for second place, there is definitely no prize for second-to-last. Hopefully the government and the medical profession will continue their efforts to build a national healthcare system that we can be justifiably proud of.

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