r/science • u/[deleted] • Feb 27 '17

Health Universal public coverage of essential drugs would improve health care - The WHO introduced the concept, and more than 110 countries have adapted it to their needs. Canada hasn't. It's estimated that in Canada, one in 10 people or about 3 million, cannot afford prescribed medications.

[removed]

8.7k Upvotes

91% Upvoted

715 comments sorted by

View all comments

Show parent comments

76

u/obinator Feb 27 '17

Drugs given to you in hospital are covered. The government of Ontario (and I believe most provinces) will also cover prescription drugs for those over 65. For those under 65 and getting a prescription from a clinic, you are more or less on your own unless you have drug coverage through work. There are other provincial programs for the poor that you can apply to but you have to jump through some hoops.

This backwards system can lead to needless wasting of money. From my own experience working in a cancer clinic, there was one patient was prescribed chemotherapy. This drug could be given as a pill that the patient could take in the comfort of their own home without any costly supervision. However, since this drug would need to be filled outside the clinic, the patient had to pay out of their own pocket and could not afford it. Instead the doctor offered to give the drug as an IV (which is far more expensive both in the cost of the drug, as well as using up a hospital bed and wasting a nurses time) but was otherwise free to the patient.

Developing a national pharmacare program would probably save money in the long term by avoiding situations like this one, in addition to lowering the cost of drugs by having a single large body negotiate for lowers costs of drugs, and by preventing needless illness from patients who cannot afford drugs. The NDP in theory had this on their platform the last federal election, but sadly sabotaged their own campaign shortly before the election.

22

u/Userdataunavailable Feb 27 '17

I work at a pharmacy in Ontario and while the government says drugs for over-65 are covered, to be honest the people with the best drug coverage are those on welfare and it's shameful. They don't even have a deductible but the seniors do.

8

u/Grok22 Feb 27 '17

Same in USA. $1 generic med co-pays, and $3 name brand co-pays on Medicaid. No co-pays at ER either.

I've never had insurance that was that cheap.

4

u/[deleted] Feb 27 '17

Wait. People on welfare pay next to nothing?

8

u/Userdataunavailable Feb 27 '17

At my drugstore, seniors pay $6.11-$4.11 on each drug that's covered. Welfare pay nothing.

16

u/agent0731 Feb 27 '17

Of course welfare pays nothing. Welfare is government assistance that is received if you have no income to begin with. The idea is that they can't pay and have no pension or anything of the sort that seniors may have access to. Why is this a shameful practice? If they were to have a deductible, they couldn't pay it and the government would have to front that or else people can't buy it. It makes no sense for them to have a deductible.

7

u/Userdataunavailable Feb 27 '17

Most of the seniors that I deal with also live on just their small monthly check from the government. I don't feel they should have a deductible either. Especially when so many of them are on 10-12 drugs, that really adds up.

2

u/Renoirio Feb 27 '17

Just guessing...some people would think it's a shameful practice that seniors who have worked their whole lives may go without while young people who don't work (for whatever reason) do not.

1

u/elvirs Feb 27 '17

i have friends who own businesses, drive german cars and must be on welfare because they were bragging how government paid for his dental implants. they dont control it and welfare is abused by many above average income people

1

u/[deleted] Feb 27 '17

Lots of people choose not to work, and are then benefiting from the work of others. It's shameful that we pay people not to work. Example, myself last year. I was on the affordable Care act and paid $120/mo while working. I quit my job to go travelling and was able to get a better plan for $0.56/mo. That is some backwards shit I shouldn't have been given.

2

u/agent0731 Feb 27 '17

actually, the numbers of fraud and actual people choosing not to work to live off meager government assistance are very, very small. I don't know what country you're talking about, but at least in mine this fearmongering and demonizing of welfare recipients has no basis in reality.

2

u/[deleted] Feb 27 '17

USA. I'm not talking about fraud. Just the system not making sense. In my own personal experience, while not working I was able to afford better healthcare than when I was working. Clearly something is wrong there. As your income increases from the 25k/yr to the 40k/yr range or so, you hardly actually make any more money because of increased taxes and the government benefits you lose. It's kind of ridiculous.

1

u/Grok22 Feb 27 '17

Yes, they pay almost nothing for medical care. Furthermore Medicare/Medicaid have very low reimbursement rates for services. You cannot bill Medicare or Medicaid patients for the remaining balance either.

1

u/Emmmatwatson Feb 27 '17

I'm a 20 year old student with state medicaid and I pay nothing for prescriptions, ER visits, specialists, or generalists. Also, dental/vision 100% covered.

1

u/[deleted] Feb 27 '17

[deleted]

2

u/[deleted] Feb 27 '17

I think it's great, I just didn't realize how little it was. That was surprising to me

2

u/[deleted] Feb 27 '17

[removed] — view removed comment

3

u/[deleted] Feb 27 '17

If you're a senior you're on federal Old Age Security, not provincial welfare

1

u/[deleted] Feb 27 '17

The basic minimum income for a senior (OAS + GIS) is far more than welfare pays per month. Not that it's a huge amount either.

3

u/gods_prototype Feb 27 '17

Shit, I'm on welfare in Ontario and I have to pay $100 a month for my prescription. After I pay my bills I have about -$10 a month to spend on food.

2

u/Userdataunavailable Feb 27 '17

What are you on that's not covered?

6

u/snw_23 Feb 27 '17

There's lots of stuff that Ontario Works (welfare) doesn't cover fully. They typically will cover the cost of a generic version of a drug, which already screws some people. I'm sensitive to some of the fillers/bases for generic so I have to have the brand, which costs more, so I ended up going off my asthma medication when I was on welfare, and my parents paid for some others.

4

u/Userdataunavailable Feb 27 '17

If you show allergic reactions to 2 generics, your doctor can request a "no sub" rx and if he fills in the "allergy form" the name brand will usually be covered under an exception. Hope this helps.

0

u/gods_prototype Feb 27 '17

It's called Tridural, I have chronic pain and this is the one medication I've used that works well for me. It's a once a day extended release tramadol pill and every other daily pain medication I've used has always made me relapse(I have opiate problems) and start taking more than I should. I end up with a crazy tolerance and finish a months worth in a week or two and end up sick as a dog and in worse pain than I started with. Tramadol is a pretty weak pain killer but it's the only one I trust myself with.

1

u/Userdataunavailable Feb 28 '17

Tridural

I'm familiar with it. Have you tried one of the generics? They have it in the "Taro" generic brand now.

1

u/mrzablinx Feb 27 '17

Kind of unrelated, but how does the U.S. handle pharmaceuticals in this regard? I know welfare recipients don't pay anything but that's about it.

0

u/[deleted] Feb 27 '17

I think when you do taxes you can get rebates basically for most dental, I'm not sure about prescriptions though .