The Ontario Liberals have just announced a pharmacare plan targeted at youths aged 25 and under which will provide full coverage for a wide range of prescription drugs. This is welcome news, to be sure. But we must ensure that policies enacted today carry forward to the longer-term goal of equitable and cost-effective health care.
Why? Universal drug plans mean national bodies negotiate fairer prices for prescription drugs. The results are dramatic. So, while some critics claim that universal prescription drug insurance is a nice idea, but not affordable - it's very clear that universal prescription drug insurance is actually the key to affordability.
The physicians involved in the Cambie trial protest that they have only medicare's best interests at heart. They point to the many western "European" nations that have two-tier health systems which are purportedly the envy of the world. Unfortunately, it's not that simple.
We hope the failure of negotiations in Ontario spurs a complete rethink of this approach. Maybe what we want to do is limit a la carte billing for doctor services in the first place, and have far clearer contractual directives against cost-ineffective treatments and towards quality, safe and high-value care.
In the arms race between germs and medicine, the global community has two complementary strategies at its disposal: First, we can develop new antimicrobials, and secondly, we can slow the emergence of resistant strains through judicious use of current antimicrobials.
We desperately need universal coverage for a full array of health care goods and services -- pharmaceuticals, mental health services, home care and out-of-hospital diagnostics. Canada is unique among OECD countries in the paucity of what it covers on a universal basis despite falling in the top quartile of countries in levels of per capita health spending.
You will know well from history that real change won't happen by providing more federal money with unconditional transfers.Real change will require helping provinces to shift the focus of our health system away from those who are relatively well resourced to new areas of care, such as essential pharmaceuticals and homecare.
A case emerged in response to an audit of Cambie Surgeries, a private for-profit corporation by the B.C. Medical Services Commission. The audit found from a sample of Cambie's billing that it (and another private clinic) had charged patients hundreds of thousands of dollars more for health services covered by medicare than is permitted by law. Dr. Day and Cambie Surgeries claim that the law preventing a doctor charging patients more is unconstitutional.
It was just 11 years ago when the World Health Organization slapped Toronto with a travel advisory, costing the city $2 billion and 28,000 jobs. This was not because of the number of SARS cases (similar in number to Singapore, which had no such advisory) but because Ottawa did not have a public health leader who could effectively coordinate with the provinces and communicate the outbreak's status to other countries.
The latest Commonwealth Study ranked Canada's health care system a dismal second to last in a list of eleven major industrialized countries. It is true that Canada's health system is fragmented and uncoordinated. Too often people fall through the cracks and we are miserable at managing patients with multiple illnesses. And too often our system feels unresponsive to the concerns of patients and their families.
So it looks like the 'magic bullet' solution has been found at last to cure Canada's health care woes: medical tourism. It's a revenue-generating solution for a cash-strapped system, we are told. A handful of other hospitals already engage in this practice. Should we break out the champagne and celebrate? Not so fast.