Monthly Archives: September 2018

Universal Pharmacare and Federalism

September 24, 2018

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Policy Options for Canada

COLLEEN M. FLOOD, BRYAN THOMAS, ASAD ALI MOTEN AND PATRICK FAFARD | SEPTEMBER 12, 2018

Canada is the only OECD country with universal health insurance that does not include coverage of prescription pharmaceuticals. Some provinces have taken steps to provide drug insurance coverage for the poor, the elderly and people facing catastrophic costs (there are some 70 drug funding programs across the country). However, access to essential medicines depends on factors such as age, medical condition, income and province of residence. It is estimated that approximately 20 percent of Canadians have no drug insurance.

A number of reports have recommended that Canada’s public health services be expanded to cover pharmaceuticals. This possibility is now under serious consideration, with the establishment by the federal government of the Advisory Council on the Implementation of National Pharmacare, led by Eric Hoskins (a former Ontario cabinet minister). The council is mandated to report by spring 2019.

This study explores options for universal pharmacare in the context of Canadian federalism. The authors define universal pharmacare as a system of insurance for important medicines that is progressively financed (i.e., contributions reflect users’ income) and has no access barriers due to costly copayments. Such a system would ensure access to important medications for millions of Canadians and improve the return on investment for the money spent on pharmaceuticals. However, there is very strong opposition to universal pharmacare from private insurers and pharmaceutical companies, which often argue for “filling the gaps” rather than comprehensive reform.

The authors outline two policy options that, based on their analysis, are feasible given the constitutional division of powers. The first would be for the provinces to delegate the power to administer drug insurance plans to a new arm’s-length agency funded by the federal government. An example of such an organization is Canadian Blood Services, which on behalf of the federal, provincial and territorial governments is responsible for the provision and management of a $500-million drug portfolio.

The second option would be for the federal government to adopt legislation similar to the Canada Health Act and provide an annual pharmacare transfer to the provinces and territories. This would give them flexibility in the design of their respective insurance systems, with federal contributions contingent on compliance with two critical criteria: (1) universal coverage should be provided for a basket of essential drugs, without copayments or deductibles; and (2) decisions over what to include in the basket should be made by an arm’s-length body (or bodies) that would negotiate with drug companies for the best prices.

The authors point out that, under either option, private insurers would not be eliminated. However, their business model would need to change to focus on brands of drugs not included in the universal public plan. Read more »

Vancouver health authority ends contract with private surgery centre over patient-pay issues

September 5, 2018

PAMELA FAYERMAN Updated: August 30, 2018

Vancouver Coastal Health is ending a contract with False Creek Healthcare Centre, and as of next week 115 surgeons and anesthesiologists with privileges at regional public hospitals won’t be able to use the operating rooms at the Vancouver clinic.

Dr. Dean Chittock

Dr. Dean Chittock

A memo to medical staff from a vice-president of Vancouver Coastal Health, Dr. Dean Chittock, said the health authority “made the decision to repatriate False Creek surgical activity back to the health authorities effective Tuesday, September 4, 2018.”

The change comes a month before new legislation comes into effect imposing harsh penalties on private clinics and physicians where medically necessary services are paid for directly by patients seeking faster treatment. Private clinics have gone to court seeking an injunction to block the bill that will be effective as of Oct. 1. There are dozens of private surgery clinics in B.C. which have always offered three streams of patient service — publicly funded (through health authority contracts), privately funded for expedited service and third-party treatment for agencies like WorkSafeBC and certain patients covered by federal government agencies.

For a few decades, health authorities have been contracting out day surgery cases to private clinics because of over-capacity problems causing long delays in non-emergency, non-urgent surgeries. Last year, Vancouver Coastal Health paid False Creek clinic $1.9 million for a range of operations or other treatments on patients who would otherwise have to wait many months or even years for procedures like hernia repairs. The year before, the private clinic received just under $1 million. In the past three years, Vancouver Coastal Health has contracted with the False Creek clinic for about 3,400 cases.

Read more »

A new physician for Princeton

September 1, 2018

Version 2

Dr. Marlin Samuels will be the newest member to the Cascade Medical team. Originally from Paarl in the Western Cape of South Africa, he completed his medical degree at the University of Stellenbosch. Dr. Samuels has experience in rural family medicine and emergency medicine with special interest in internal medicine and infectious disease. Dr. Samuels is an adventurer having worked onboard cruise ships prior to relocating to Canada. He was attracted to Princeton by the surrounding nature and abundance of outdoor activities in the area as well as Princeton’s reputation as an exceptionally kind, caring and welcoming community for new doctors. Dr. Samuels has recently completed the Spring intake of the Practice Ready Assessment Program of BC and will be providing a 3 year return of service in Princeton beginning in late August. We hope that you will warmly welcome Dr. Samuels to our community. 

To get on the waitlist for a family doctor, please stop in at Cascade Medical Centre and fill out our Request for Attachment form and return it to the clinic at your earliest convenience, you can also find a copy on our website at www.cascadeclinic.ca.

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