National Pharmacare?

[SLM]

Post-transplant patient swallowed by exceedingly high medication cost | Toronto & GTA | News | Toronto Sun

This is obviously not a quick nor an easy "fix", but there are good point made within the article.

“The truth is, why have a public health system were you can get the diagnosis for free but the treatment is beyond your reach? That makes no sense.”

That kind of wraps it up in a nutshell. And I'm not necessarily advocating that all prescription medication be lumped in with existing healthcare coverage. But it certainly seems extraordinarily wasteful to pay the high cost of organ transplant and then let people fall into financial ruin just to ensure the transplanted organ does not fail. Who does that benefit in the end? Certainly not the individual, does that benefit society?

This specific individual spoke of not wanting to let himself have a lifestyle that affords him the lowest premiums available, but you've got to ask how many people actually do? Are people opting to go on assistance because they simply cannot maintain any kind of lifestyle by 'playing by the rules'?

 

[L Gilbert]

The issue definitely needs to be addressed. Not sure what the answer may be, but if I were the manufacturer of the drugs the guy needs, I'd be shipping him his meds for free. But then I think people are more important than profits.

 

[SLM]

The issue definitely needs to be addressed. Not sure what the answer may be, but if I were the manufacturer of the drugs the guy needs, I'd be shipping him his meds for free. But then I think people are more important than profits.

That would be okay for this guy, it would probably be good promo advertising for the drug manufacturer too. I think though that this is not an isolated problem and realistically they can't do that with everyone, nor should they have too. I also think that people are more important than profits but the drug manufacturer also employs people, who consume good and services within the community, etc, etc. And investor's have a right to see a return on their investment. It's all a very complex tapestry.

But it's clearly ridiculous to have a system that will pay for the transplant but not for the followup. And when the followup can be, in the end, as costly that's both unfair and rather wasteful. Rightly or wrongly we have determined in this nation that every person is covered for medical treatment, so we need to ensure that they are covered, not in some half-assed way but actually covered.

The entire health system needs a complete overhaul and reassessment, even to look at what's not currently covered and determine what is the best benefit for individuals and society as a whole. I'm just not sure what that would look like.

 

[damngrumpy]

Some medical issues are more important than profit for sure but we have to think
once again about long term solutions. Medicare, and education in this country have
to be seen as investments rather than expenses. For example everyone benefits
from a well educated society, business and the trades benefit and in the long run
our workforce has higher productivity. The problem is some of brightest and best
people are shut out of the process because they can't afford to get the education they
need. If we were to link the post secondary education to service in communities to
pay some of the costs we could change the equation.
Health Care and pharmacare assisted by governments helps companies because they
don't have to pay contributions to high priced for profit managed health care companies
once again it becomes a value for service that benefits everyone, but again we need
to fund it properly and understand what we are funding.

 

[L Gilbert]

That would be okay for this guy, it would probably be good promo advertising for the drug manufacturer too. I think though that this is not an isolated problem and realistically they can't do that with everyone, nor should they have too. I also think that people are more important than profits but the drug manufacturer also employs people, who consume good and services within the community, etc, etc. And investor's have a right to see a return on their investment. It's all a very complex tapestry.

That's just what I'd do and I don't expect that manufacturers should have to. I would do it for anyone who had the same choice between dying or losing everything that supported that life. I wouldn't do it for everyone, just those people.

But it's clearly ridiculous to have a system that will pay for the transplant but not for the followup. And when the followup can be, in the end, as costly that's both unfair and rather wasteful. Rightly or wrongly we have determined in this nation that every person is covered for medical treatment, so we need to ensure that they are covered, not in some half-assed way but actually covered.

The entire health system needs a complete overhaul and reassessment, even to look at what's not currently covered and determine what is the best benefit for individuals and society as a whole. I'm just not sure what that would look like.

I agree, but I doubt strongly that any more than a few politicians would actually work for any length of time on the issue.

I wonder why the guy thought he couldn't come up with the $8000/year for private insurance premiums that would cover his meds. I'd sooner spend $8K of my RRSPs per year on it than spend the $2000 to $4000 per month for the meds till my RRSPS were totally drained (plus savings and whatever else). Maybe I missed something in the article.

 

[SLM]

I wonder why the guy thought he couldn't come up with the $8000/year for private insurance premiums that would cover his meds. I'd sooner spend $8K of my RRSPs per year on it than spend the $2000 to $4000 per month for the meds till my RRSPS were totally drained (plus savings and whatever else). Maybe I missed something in the article.

Wouldn't he be disqualified because of a preexisting condition though? And that seems steep for someone to get into as a "just in case this ever happens to me" decision, so I don't see many people opting into that kind of insurance beforehand.

 

[taxslave]

Some medical issues are more important than profit for sure but we have to think
once again about long term solutions. Medicare, and education in this country have
to be seen as investments rather than expenses. For example everyone benefits
from a well educated society, business and the trades benefit and in the long run
our workforce has higher productivity. The problem is some of brightest and best
people are shut out of the process because they can't afford to get the education they
need. If we were to link the post secondary education to service in communities to
pay some of the costs we could change the equation.
Health Care and pharmacare assisted by governments helps companies because they
don't have to pay contributions to high priced for profit managed health care companies
once again it becomes a value for service that benefits everyone, but again we need
to fund it properly and understand what we are funding.

Instead we pay high premiums and taxes to support a high priced and inefficient bureaucracy/

 

[L Gilbert]

Wouldn't he be disqualified because of a preexisting condition though?

Doesn't seem to be the case as the way I read it, he is trying to get reduced premiums on the private insurance.

And that seems steep for someone to get into as a "just in case this ever happens to me" decision, so I don't see many people opting into that kind of insurance beforehand.

Perhaps the reason for the steep premiums is because of the pre-existing condition.
Still $8K per year is loads cheaper than $4K a month.

 

[SLM]

Doesn't seem to be the case as the way I read it, he is trying to get reduced premiums on the private insurance. Perhaps the reason for the steep premiums is because of the pre-existing condition.
Still $8K per year is loads cheaper than $4K a month.

Oh I see what you're getting at. No that's not private insurance, that's Trillium which is a subsidized provincial drug plan. They annually review the deductible and base it on your prior years income. They originally assessed it against his income for the year when he was working, that's the $8000 deductible, they reassessed and based it on his reduced disability income to a $4,400 deductible. Yes it is still loads cheaper than the $4k per month, but if he's on disability and she's on EI, I would imagine that's still a pretty big chunk of their income to pay for the medication required after his healthcare paid transplant.

 

[L Gilbert]

Oh I see what you're getting at. No that's not private insurance, that's Trillium which is a subsidized provincial drug plan. They annually review the deductible and base it on your prior years income. They originally assessed it against his income for the year when he was working, that's the $8000 deductible, they reassessed and based it on his reduced disability income to a $4,400 deductible. Yes it is still loads cheaper than the $4k per month, but if he's on disability and she's on EI, I would imagine that's still a pretty big chunk of their income to pay for the medication required after his healthcare paid transplant.

Oh, ok. I misunderstood a little of it.