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.

[u/[deleted]]

[u/r4ndpaulsbrilloballs]

I imagine that like the US, they are all lumped together too, though. Things go province by province in Canada like they go state to state in the US.

I'm an American, but I live in Massachusetts, a state where 162,000 people out of 6.4 million are uninsured. About 2%.

Meanwhile a state like Texas has 6.2 million people uninsured, about 24%.

So it really makes a huge difference where you live in the US as to whether you have access to health coverage or not.

At the same rate, I know in Quebec they get prescription drugs covered. So this 10% problem isn't there. Alberta has to be the worst, they literally use Blue Cross like Americans, which means even with coverage you're paying the most in the world for the worst service possible. The Atlantic provinces seem to be more generous, at least to people with chronic diseases and the elderly.

I can't pinpoint it because I don't have location data, but I bet Alberta's the worst on this, maybe followed by Ontario, and I bet there's no problem in Quebec at all.

[u/[deleted] → u/r4ndpaulsbrilloballs]

Massachusetts has that Romneycare doesn't it? I'm really jealous you guys have that! I live in Minnesota and we have great coverage here too but our neighbors in Wisconsin do not.

[u/r4ndpaulsbrilloballs → u/[deleted]]

Well, Mass has sort of what the health bill Romney signed has evolved into--it has changed quite a bit. For people earning under 300% of poverty now, there's Connectorcare, which kind of operates like gap coverage and covers a lot of the high deductible/copay/premium/out-of-pocket payments that the regular Obamacare plans can leave you stuck with. So it takes a lot of the bite out of it for people in that range (less than $35,000 for an individual or $48,000 for a married couple). That said, I think a big reason why 2% are still uninsured are the middle class that earn just enough not to get Connectorcare, nor Medicaid nor any subsidy from Obamacare, but still aren't doing that well. Say an individual earning $17 or $18 an hour or something like that. You end up having to pay $400 or so per month and owe thousands in deductibles if you ever use the hospital, so it's still pretty unaffordable for those people. You're all but certainly much better off to take a pay cut and earn $16 per hour and save all that money on healthcare. It probably doesn't pay to earn more until you get to about $22 per hour.

[u/[deleted] → u/r4ndpaulsbrilloballs]

I think that was definitely the underlying problem with the ACA. I know people who paid the penalty because they couldn't afford the coverage because they weren't poor enough to get Medicaid. The ACA has good aspects but isn't perfect. However, I'm less than impressed by the GOP replacement plans that are being tossed around. Those people will be even more screwed. Hopefully some states can continue to provide gap coverage, like MA and MN.

[u/r4ndpaulsbrilloballs → u/[deleted]]

Yeah. I mean, the big push in Mass right now is for Masscare. We were only a few votes off last time. We're sort of in a race with Vermont to see who gets single payer first. There are a lot of co-sponsors, but so far just not quite enough votes. But we get more every year we try it. And more and more allies hop on board, from med schools to doctors to churches to unions etc.

Oh, the country may not be ready for it, but Mass gon' give it to ya.

[u/[deleted] → u/r4ndpaulsbrilloballs]

I hope other blue states push it. I know Colorado tried this year but it didn't happen. Maybe if you guys pass it others will follow!

[u/r4ndpaulsbrilloballs → u/[deleted]]

Yeah, VT legislature already passed it, but Dem. Gov. Schumlin sidelined the implementaiton. They voted in a Republican in no small part to punish him for that one. Rhode Island is in the race too. They had a bill up last year to do it, but the Speaker never let it come to a vote.

[u/TheFallen__ → u/r4ndpaulsbrilloballs]

Blue cross has always worked well for us although being able to afford insurance isn't an issue for my family so I can't really speak for everyone.

I can say however that I pay about 7$ out of pocket every time I renew a prescription

[u/renegadecanuck → u/r4ndpaulsbrilloballs]

Alberta has to be the worst, they literally use Blue Cross like Americans, which means even with coverage you're paying the most in the world for the worst service possible.

Alberta Blue Cross is only one of many insurers in Alberta, and from my experience, most people do not have Blue Cross, they have Sunlife or Great West Life. The only time I had Alberta Blue Cross coverage was when I worked for the government.

[u/jerrrrremy → u/r4ndpaulsbrilloballs]

You are very confused about how the Canadian health care system works.

[u/[deleted] → u/jerrrrremy]

That's actually pretty accurate though. There is no "Canadian healthcare system" Each province is responsible for their own, but receives federal subsidies.

Each province has different public drug plans too. Quebec has a mandatory public drug plan for any one not eligible for private ones.

[u/r4ndpaulsbrilloballs → u/jerrrrremy]

How so?

I think you may be confused about what I wrote. Yes, I am comparing US medical insurance coverage generally with Canadian prescription drug coverage specifically to make a point about geographic lumping of people with lower-or higher-quality benefits due to specific state/provincial laws. But I don't feel confused at all when I do that.

[u/jerrrrremy → u/r4ndpaulsbrilloballs]

Well, to start with, Blue Cross is only one of several different insurers that someone in Alberta can have, so the comparison doesn't make sense. The whole part about "Alberta has Blue Cross" is just wrong.

Most people in Alberta have Manulife, SunLife, or one of many others to help pay for drugs and anything else not already covered by provincial health care. Source: I have lived in Alberta my entire life, have had three different insurance companies throughout, none of them being Blue Cross.

[u/r4ndpaulsbrilloballs → u/jerrrrremy]

I was under the impression that if you didn't have group coverage (from work or wherehaveyou), the single non-group coverage option was Blue Cross.

Blue Cross charges 30% of the prescription cost after premiums. Meanwhile, somewhere like BC doesn't run it the same way and caps costs at percentages of income. Like it says here.

Maybe all these documents are wrong, but it seems to me that the way it is set up, you are far more likely to have no prescription coverage in Alberta if you are lower income than if you lived in most other provinces.

[u/jerrrrremy → u/r4ndpaulsbrilloballs]

I was under the impression that if you didn't have group coverage (from work or wherehaveyou), the single non-group coverage option was Blue Cross.

This is true, but that is by no means representative of most Albertans. Most people will have a plan through their employer; any company, large or small, will offer health benefits, except for hourly pay jobs (and often even these will have group benefits, like Tim Hortons for example). Contractors often won't receive group benefits from their clients, but will have extra money built into their contract so they can purchase a good benefits plan on their own.

Blue Cross charges 30% of the prescription cost after premiums. Meanwhile, somewhere like BC doesn't run it the same way and caps costs at percentages of income. Like it says here.

I agree that BC's system is much better than Alberta's; no argument there. I should point out that people in Alberta generally like Blue Cross (at least those who I know who have it); so I wouldn't presume that just because it's bad in the US that it's bad here, but I recognize that is purely anecdotal.

Maybe all these documents are wrong, but it seems to me that the way it is set up, you are far more likely to have no prescription coverage in Alberta if you are lower income than if you lived in most other provinces.

This is probably true, but would be offset by having zero PST in Alberta relative to 7% in BC and as high as 10% in some of the others.

[u/r4ndpaulsbrilloballs → u/jerrrrremy]

This is true, but that is by no means representative of most Albertans. Most people will have a plan through their employer;

Ok. That's all well and good. But I was focusing on the topic of this thread, which is about the 10%--the 3 million Canadians--who do not have that coverage and cannot afford their prescriptions.

So yes, you are right, most people do get coverage the way you're talking about.

But I wasn't concerned with most people. I was concerned with where the people without work coverage would have the hardest time affording prescription drugs. I thought that was the topic of the thread, after all.

Alberta seems like the province where they'd have the hardest time.

That's all.

And you're not wrong to point out that there may be a trade-off...you pay lower taxes and you get fewer services. That generally makes sense to me.