Shock and dismay understate the way I felt after reading Lena Scholman’s opinion piece, “A short walk and the cure for what ails us“, in the Hamilton Spectator. Can Scholman be naïve enough to believe that a short walk is the cure all that should replace universal pharma care?
Scholman points out that, “The government already subsidizes the medication of seniors and the most vulnerable.” And that, “the biggest savings are for the expensive drugs for rare conditions. So do we need a universal drug-coverage Program? Or, so we need free drugs for five to 10 per cent of the population?”
But when Scholman stated, “when everything is free, our default is to take the easy way — and demand things we don’t really need,” then I knew she was living in a world vastly different from Canadians who are have precarious employment or make up our nation’s working poor.
Let’s get a few things straight. The Canada Health Act provides coverage for physician services, hospital care and pharmaceuticals used while in hospital. That means that post surgery painkillers are available free for the three or so days a patient is in hospital, but not for the three week period when they would be required at home. For an individual without coverage the cost of easing pain may have to be balanced against rent or groceries especially when they are also prescribed antibiotics, stool softeners, and other medications necessary to return their health.
Or, how about the single mother of two children who is employed by a reputable university as a sessional instructor which means she’s living at or below the poverty line without any benefits. Both of her children fall ill, but there is only enough money to fill one prescription. Which child should she choose Ms. Scholman?
Or, the parent working two or three part-time jobs to make ends meet. Their child is diagnosed with strep throat — not a big deal, not life threatening. That is, until it goes untreated with simple antibiotics and turns into scarlet fever which can not only kill, but leave a surviving child with heart and hearing issues.
By the 1970’s provincial governments recognized that the rising costs of prescription drugs was becoming a financial burden on those with low or fixed incomes. Provinces began offering drug coverage to certain sectors of the population, including those receiving social assistance and seniors. But, by the 1990s, some provincial governments realized that this was a real issue for sectors of the population at risk of experiencing financial hardships. Included in this group were Canadians between the ages of 18 and 34, living on low to middle incomes, or working part-time.
It also needs to be pointed out that there have been significant changes made to health care system. Conditions that used to be treated in hospital are now treated at home thanks in part to drug therapy. But, drug therapy only works if the patient can afford to purchase the drugs. And, these need not fall into the category of expensive drugs for rare conditions. These prescriptions include the $30 that’s not in the budget for ten days of antibiotics; $300 per month for antifungal medication that will continue for a year; $180 for puffers; or on-going medication for high blood pressure.
In her paper, Catastrophic Drug Coverage in Canada, Karin Phillips states,
“some studies have demonstrated that increased out-of-pocket costs for prescription drugs have resulted in negative health outcomes. For example, one researcher found that patients 65 or older were less likely to fill their prescriptions when they had to pay for them. This in turn resulted in increases in their rates of hospital admissions, emergency care and visits to physicians. These results have led health policy researchers to argue that prescription drugs need to be considered medically necessary under the Canada Health Act.”
So, Ms. Scholman, although I too believe in preventative measures and do think that walking is a great way to stay fit, your argument that, “when everything is free, our default is to take the easy way — and demand things we don’t really need,” is an insult to Canadians. Thank you, but I really don’t want you advocating for my health care because it’s well documented through good research that we need universal pharma care and we need it now.