The following letter was sent to the three major New Brunswick newspapers.
In the early 1960s Tommy Douglas, then premier of Saskatchewan, defied entrenched interests in his province to establish Medicare, the system of public and universal health care we know today. The success of the Saskatchewan experiment led Prime Minister Lester Pearson to adopt Medicare across Canada, ensuring universal health care for everyone, regardless of income or employment status.
The Canadian Association of Retired Persons (CARP), Fredericton Chapter, believes that this represented a bold vision, a willingness to think big, present new ideas, and to take a stand to help the poor and middle class.
CARP is advocating that a similar vision is needed today with Pharmacare, and New Brunswick can potentially lead the way. Prescription drugs are an increasingly essential part of health care, but their growing costs are undermining the principles of universality and accessibility, which was central to the spirit of Medicare in Canada. According to a Government of New Brunswick report entitled., Developing a Drug Plan for Uninsured New Brunswickers, spending on prescription drugs has more than doubled over a decade from $300 million in 2000 to $625 million in 2010.
Currently, not all New Brunswickers are covered by a prescription drug program. So the announcement by the provincial government of a plan to cover the uninsured is certainly welcome news. It is encouraging that the Alward government is making this a priority and it is good that the plan does not have deductibles (threshold of prescription drug costs whereby one becomes eligible for coverage). However, the plan lacks details and ultimately keeps the American-style, privatized patchwork of current insurers intact, with its administrative costs and gaps in coverage.
With universal health care seen as a right in Canada, the lack of prescription drug coverage is unacceptable.
The proposed New Brunswick plan would be administered by a private agency Blue Cross which has in the past not provided the full cost of medication. Also, not all drugs are approved by Blue Cross for coverage this would be a serious concern especially for medications a patient may need to survive. Would the new plan by the provincial government provide truly universal coverage? It is a known fact that proper prescription drug coverage can lower hospitalization rates, thereby lowering health care costs. However, if across-the-board coverage for a full gammut of drugs is not built into the proposed plan, the principles of universality and accessibility is merely being paid lip service, leaving those who need coverage the most in the lurch.
A further concern with the new plan is the size of the co-payments and premiums. Would these costs deter people especially low-income earners from purchasing prescriptions? An expectation is that, once the plan becomes mandatory beginning in 2015, increased participation would lead to a reduction in fees. However, the government has been vague on how premiums will vary with income once the plan becomes mandatory. This is crucial to the plans affordability. At best, one can be very cautiously optimistic on this point.
The collection of premiums involves significant administrative/overhead costs especially when compared to tax collection to fund public services and is essentially regressive, amounting to a handout to for-profit insurers who are already earning billions.
CARP believes that what is needed is a universal plan funded by the province, not an American-style private insurance plan which punishes those who can least afford to pay for needed medications. A public and universal pharmacare program would offer similar benefits to those currently benefitting from Medicare a competitive advantage for business by lessening the burden on employers, reduction in administrative costs, and more workplace stability as pharmaceuticals would not be the subject of labour-management conflicts.
A report from the CD Howe Institute stated that amalgamating drug programs and providers under a single, universal, public pharmacare program would lower administrative costs and across Canada would save $1 billion per year. As well, drug costs would be lowered through the increased bargaining powers of a single provider.
For New Brunswick, a provincially-provided pharmacare program should include employers in a form of cost-sharing, with employers who have higher revenues paying higher rates to avoid a disproportionate burden on small businesses (the lower administrative costs would still amount to overall savings for employers).
A public and universal pharmacare program is the right move socially in helping the poor and middle-class and makes sense in promoting fiscal responsibility as well as providing an attractive climate for business and investment. New Brunswick was one of the last provinces to provide a prescription drugs program, but rather than offering something inadequate, we can lead the country and serve as an example in developing a truly public and universal prescription drugs program.
As TV personality Mike Holmes from “Holmes on Homes” would say, “Make It Right.”
Suzanne Maltais, Chair
CARP Fredericton Chapter #27