Let me start saying that from my "experience," and that's what this article is all about (not expertise), probably most of my visits to doctors and specialists as a patient have been a waste of my time, plus a misuse of all kind of resources depending on where one is living and what kind of insurance one would have.
Across Canada, the tragic spike in opioid-related deaths has brought to national attention the large and complex issue of drug use and misuse. As fentanyl-related overdoses are gripping the country, there is a connected, but separate crisis of doctor-prescribed opioids being increasingly used on a regular, long-term basis.
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.
Many believe pharmaceutical companies are repugnant. There were several serious issues that built the foundation of the anti-pharma movement. While not all companies are guilty or equally responsible, many behaved unethically. They didn't always fully disclose research and safety data if it didn't support their product. They attempted to prevent researchers from voicing serious concerns. They created inappropriate relationships with physicians, leaving the impression that doctors were being bought, and sometimes that was true. This had to change.
Today's disjointed pharmaceutical policy may be described as a Shakespearean tragedy -- a flawed system that will always end with demise. The relationship between health care policies, the funding of prescription drugs and public access to medically necessary medication is fragmented. It is in need of political leadership.
When the topic of health care and pharmaceutical drugs comes up, the discussion usually turns sooner or later to the high prices we pay. At the upcoming meeting of the Council of the Federation in Yukon, the Canadian health care system will certainly be on the agenda. But a national pharmacare plan would do more harm than good.
It's natural for any industry to undergo changes, but few industries have experienced as many rapid changes as the pharmaceutical and health care ones. To remain relevant among these digitally wired consumers, big pharmaceutical companies have adjusted, making visible efforts to grab the audience's attention through web and mobile presence.
If Canada is to implement national pharmacare, surely we want to know more about the drugs we'll be paying for. To this end, we must tackle a pre-existing challenge: we must open up the evidence our drug regulator houses concerning drug safety and effectiveness. For decades Health Canada has kept that information confidential at the behest of drug manufacturers. This practice limits the ongoing evaluation of a drug's safety and effectiveness and, in turn, provincial and territorial governments' decision-making about which drugs to pay for, not to mention physicians and patients who make decisions about which drugs to prescribe and take.
Today, doctors' offices are inundated with people who have been harmed more than helped by these drugs. Thousands more are dead. And yet the marketing continues, with pain specialists and advocacy groups opposing moves to curtail opioid prescription, their efforts financed by the very companies that make these drugs.
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.
The glaring gaps in drug coverage for Canadian children are made stranger by the economic dimensions of the issue. Children's health care represents a drop in the ocean of health care budgets -- extending universal drug coverage to children would constitute a small fraction of total pharmaceutical spending.
Cities have to spend this money, taken from local taxpayers, because Canada's medicare system is the only universal, public health care system among developed countries that does not include universal coverage of prescription drugs. It is not wrong for cities to care for their employees. But leaving these costs to the cities makes about as much sense as requiring every homeowner to maintain the roads and infrastructure surrounding their property. Here's why.
A new study in the Canadian Medical Association Journal with health economist Steve Morgan as lead author argues a national universal care drug program would not result in substantial tax increases. It seems the time is ripe to finally complete our universal system of public healthcare coverage by adding a national public drug plan. If anything, these cautions should serve as guideposts to make sure a new national drug plan is not only effective but also designed in a fiscally sustainable manner.
The federal government plays a vital role in pharmaceutical drug regulation. We have many reasons to be proud of the systems for drug safety already in place in Canada. Yet there's room for significant improvement. Canadians deserve safe, effective, accessible and reliable pharmaceutical drugs when they need them. The only way to do this is through perpetually improved systems framed by transparency and openness.