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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Princeton Health Care Steering Committee Report

August 20, 2018

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July 27, 2018

Submitted by Edward Staples, Princeton Health Care Steering Committee

On Tuesday, July 17 , the Princeton Health Care Steering Committee (PHCSC) held its monthly meeting at Princeton General Hospital. The PHCSC was formed in 2013 to provide a mechanism for Interior Health, the Town of Princeton, the Regional District of Okanagan-Similkameen, Cascade Clinic, Princeton General Hospital, and community organizations to work together to support stable, sustainable and accessible health care in Princeton.

This month’s meeting was attended by representatives from the Town of Princeton, Area H (RDOS), Cascade Medical practitioners, Princeton General Hospital staff, Interior Health, BC Ambulance Services, Princeton and District Community Services, Princeton Family Services, RCMP, the Princeton community, and Support Our Health Care (SOHC). The meeting was chaired by Interior Health administrator, Susan Brown.

The following are communication points from the meeting:

  • Jim Bruce is the new Area H (RDOS) representative, replacing Sandra Lawlor who resigned her position on the committee; the Steering Committee thanks Lawlor for her contributions in support of the committee’s activities
  • Jim Bruce made a presentation on issues pertaining to the pharmaceutical needs of new people coming to Princeton (see attached); Dr. Van Der Heide will take the information forward to see about posting on the Cascade Clinic Website (www.cascadeclinic.ca)
  • Dr. Van Der Heide provided information on the waiting list for people wanting attachment to a practitioner; there is an application form available at Cascade Clinic
  • the Princeton Community Paramedicine program provides a bridge to health servicedelivery gaps in the community, identified in collaboration with our local primary care team. Our Community Paramedics have become an integral part of our community- based team of health service providers. People interested in accessing their services can contact the Princeton Home Health Nurse at 250-295-4442.
  • in response to queries from local residents about Princeton’s Alzheimer’s support group, the following information is provided:
    • support for Alzheimer’s caregivers is provided through the Caregiver Support Group run by Jennifer Clement, Home Health Social Worker
    • the group meets the 2nd and 4th Thursday of the month giving support for people providing home care to loved ones with declining abilities
    • no referral is necessary; to participate in the group, caregivers can contact Jennifer Clement by phoning 250-295-4464

• the BC Alzheimer’s Society in Penticton would like to start a separate Alzheimer’s support group in Princeton and is looking for volunteer help. If interested, local residents can contact Jennifer Clement at the number above

Letter to the Editor

July 30, 2018

Pharma

Letter to the Editor

Princeton Similkameen Spotlight

William L. Day

11 July 2018

The House Of Commons All-Party Standing Committee on Health has recently endorsed and recommended the implementation of a Canadian Pharmacare Program.

Many currently healthy people are not aware that prescription drugs are covered by our Canada health insurance only while the client is in hospital. Insurance outside the hospi- tal varies greatly among provinces and territories.

For example, the same out-of-hospital cancer treatment can cost you $0 in Nunavut; $3,000 in BC; $20,000 in PEI.

Currently, Canadians pay more for prescription medications than citizens in any other of the 29 wealthy OECD countries except Switzerland and the USA.

More than three million Canadians are under-insured or uninsured for prescription drugs outside approved hospitals.

Researchers have found that overall, 5.5 per cent of respondents across Canada reported they couldn’t take their medications as prescribed because of costs. In B.C., the proportion falling through such cracks in the health system was highest among all provinces and territories, at 8.11 per cent.

Unlike all other industrialized countries, neither the USA nor Canada have established a drug plan that would allow their national governments to negotiate drug prices on behalf of their entire population.

In summary, Canada remains the only industrialized country with universal health insur- ance but no national Pharmacare strategy for its citizens.

The Support Our Health Care Society (SOHC) of Princeton will be doing its best to acquaint Similkameen residents with our collective problem and opportunity. We will be providing information in Princeton at retail outlets and surveying our local public on the issue. We intend to inform our MPs and MLAs of our activities and findings. To date, they have been very receptive. Readers are encouraged to go to the government website to read the original complete document and join the discussion:
https://www.letstalkhealth.ca/pharmacare.

The power to engineer this change lies with us, with Ottawa and our collective Members of Parliament and MLAs. They are listening and waiting for us to signal our support for change.

The Time Has Come.

Yours respectfully,

Bill Day, Vice President, Support Our Health Care Society, Princeton BC

Share your story……

July 26, 2018

If you have you been hospitalized for care outside of your home town, and would like to share your story about your experience of getting back home afterwards, please participate in this study.

Email, contact: research@interiorhealth.ca or

phone: 250-469-7070

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Patients Travelling From Urban Geographies To Rural Hospitals For Procedural Care: A Realist Consideration

July 19, 2018

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Patients Travelling From Urban Geographies To Rural Hospitals For Procedural Care: A Realist Consideration

“One unknown predictor of success, however, will be the willingness of urban surgical patients to travel to rural sites for care. This review explores the question of willingness to travel through a rural lens, reversing the usual scenario of rural patient travel to urban centres.“

http://med-fom-crhr.sites.olt.ubc.ca/…/RER-Scoping-Review-F…

 

 

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SOHC Discussion Paper

Developing an Improved and Sustainable Health Care Model for Princeton, B.C
Support Our Health Care has released a discussion paper in order to get feedback from the community, politicians and professionals about the state of local healthcare and what the long term solutions should be.
Download PDF Here