Health-care costs on critical list (canada)

In an offhand comment last week, Prime Minister Paul Martin rejected the idea of a comprehensive national pharmacare plan. He insisted the proposal is simply unaffordable.

The provincial premiers disagree. Last month, they unanimously called upon Ottawa to introduce and pay for a national plan to provide Canadians with prescription drugs, but neglected to estimate the cost of the program.

That cost is bound to be considerable. Independent experts suggest the total could range anywhere from $7 billion to $12 billion a year.

Martin has promised no more than $9 billion in additional federal funding to improve the quality of medical services and to subsidize the introduction of a limited pharmacare plan to protect Canadians from catastrophic drug bills.

As it happens, the Ontario government already has in the Trillium Drug Program a limited system for subsidizing the purchase of drugs. To hold down costs, this plan is based on a hefty geared-to-income deductible and covers only a selection of essential prescription drugs.

For example, the program does not subsidize the purchase of triptans, the only kind of drug that can relieve the suffering of excruciating migraine headaches. Triptans are relatively new and expensive. Each pill costs about $20.

That's twice the cost of a six-month supply of HCT, an old drug commonly prescribed for high blood pressure.

As one might expect of a government-run drug program, HCT is included in the plan, while triptans are excluded. It sometimes seems that if you can afford a drug, it's covered by the Trillium plan; if you can't, it isn't.

That, of course, is an exaggeration. The Trillium plan is designed to help low- and middle-income families acquire virtually all proven, life-saving (as distinct from pain-relieving) drugs without going bankrupt.

But is that good enough? Under the Ontario Health Insurance Plan, any patient with a sore throat or a runny nose is entitled to consult a physician at no charge. Furthermore, OHIP also covers the costs of expensive diagnostic tests and surgery, including elective procedures such as hip replacements that serve mainly to relieve pain.

Why, then, should the provincial drug plan not also cover the entire cost of every health-enhancing and pain-relieving drug prescribed by a physician?

The answer is so obvious that even a provincial premier should readily understand: Such a program would be ruinously expensive.

A universal and comprehensive pharmacare program with no deductible would be wide open to abuse. If the government were to hand out triptans free of charge, the number of patients taking these expensive drugs for something less than a severe migraine would be sure to skyrocket.

Much the same problem already plagues OHIP. Many patients think nothing of running off to their family physician whenever they get a head-ache or some other minor ailment, because they don't have to pay a cent for the service.

This recklessly profligate arrangement cannot long continue. OHIP costs are already escalating out of control. Last year, the Ontario government spent $28.9 billion on health care, up from $19.7 billion just five years earlier.

In a desperate bid to cover soaring health-care costs, the McGuinty government has broken its most solemn election commitment not to raise taxes, by introducing the Ontario health premium. Once this new tax is fully phased in next year, Ontario residents with more than $20,000 in taxable income will typically have to pay out anywhere from an extra $300 to $900 a year into the province's coffers.

Yet this tax premium is only a stopgap measure. It will take in only about $2.5 billion a year.

In an aptly entitled report, Paying More, Getting Less, Brett Skinner of the Fraser Institute points out that Ontario health expenditures already absorb 42 per cent of all provincial revenue. He projects that if current trends continue, that ratio will rise to 50 per cent of all revenue by 2013 and an unsupportable 75 per cent by 2023.

Let's face it. Free physicians' services and free hospital services are no more sustainable than a free pharmacare plan for handing out drugs.

Sooner or later, Ottawa and the provinces will have to open up their grossly inefficient, government-run, medicare monopolies to some healthy, efficient and affordable private-sector competition.

I only hope that socialized medicine will be clearly recognized as a failure in other countries before a future president decides we should have it. By the time Canada's healthcare costs equal their GNP, even Democrats should be able to figure out that the free market deserves a chance.

2 posted on 8/20/2004, 12:49:08 AM by AZLiberty (Proud to be an infidel.)

In an offhand comment last week, Prime Minister Paul Martin rejected the idea of a comprehensive national pharmacare plan. He insisted the proposal is simply unaffordable.

But, but, but, healthcare is a right.

Yet at the same time we're importing a lot of our free health care problem. We're trying to provide free health care for citizens of another country.

At least Canadians pay when they go to the US for healthcare. I have no idea about the south of the border...)

Well --- from south of the border, the few with money do pay and they pay in cash --- money is no object with them because they have so much but the majority are indigent and have no way to pay. They come over to the hospitals and clinics and never are expected to pay.

Why don't the Canadians just enact a tax on all those cheap prescriptions being filled for Americans by Canadian pharmacies? That should fund their health care plan.

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