The first shoe fell with the March 2013 provincial budget announcement that the Seniors Drug Plan would be terminated and replaced with a means-tested pharmacare plan on January 1 , 2014 . This occurred despite the government ’ s categorical , preelection assurances that the Seniors Drug Plan would not be touched .
Waiting for the Second Shoe to Drop
by Noel Somerville Chair , Seniors Task Force , Public Interest Alberta
The first shoe fell with the March 2013 provincial budget announcement that the Seniors Drug Plan would be terminated and replaced with a means-tested pharmacare plan on January 1 , 2014 . This occurred despite the government ’ s categorical , preelection assurances that the Seniors Drug Plan would not be touched .
It was also announced that this change would save the government $ 180 million . However , when the government cuts its costs , it actually transfers these costs . In this instance , the costs are not being transferred to all seniors , only to those who require prescription drugs .
It was suggested that the new plan would be based on BC ’ s income-based model that applies to all BC residents , not just seniors , and has been in existence for the past decade . This model makes the government the last payer , and provides coverage only after the patient has already spent a fixed percentage of their ‘ net income ’ on prescription drugs . That percentage can be 0 %, 1 %, 2 %, 3 % or 4 % of net income , depending on the patient ’ s income level .
It was further announced that the specific details of the Alberta plan would be announced in due course ; but since then , we have heard nothing . Speculation is that , to avoid the expected backlash , the plan will be kept under wraps until after Premier Redford ’ s leadership review at the November PC convention . This speculation is reinforced by leaks from government that the new plan will not be introduced on January 1 , 2014 , but there is no indication of when the new plan will be implemented .
The government ’ s rationale for dropping the Seniors ’ Drug Plan is that some seniors can afford to cover their own drug costs , and taxpayer dollars should be used to cover only the poor . That ‘ ability to pay ’ principle is the one that Canadians rejected in our Medicare system and in the Canada Health Act . We said that medical care should be available on the basis of need , not ability to pay .
Abandonment of that principle is the reason why income-based plans , like the BC model , do not work . So many people , particularly seniors , no longer able to afford the medications they require to stay healthy , end up costing the health care system more than the savings on drugs .
This is not surprising when one considers that , in the population at large , 80 % of prescription drugs are taken by 20 % of the population . However , in the over- 65 age group , the proportion dependent on medications to stay healthy must be well in excess of 90 %. Further , for many seniors , this dependence comes at the same time that they or their spouse lose the prescription coverage they had through their working lives .
By abandoning the Seniors ’ Drug Plan and replacing it with an income-based plan , the government is not only ignoring the crucial role that prescription drugs play in keeping seniors healthy and out of hospital , it also ignores the fact that prescription medications are an integral part of our health care system as essential to population health as doctors and hospitals .
The Seniors Task Force of Public Interest Alberta recently adopted a position paper on Pharmacare that is available on the PIA website ( www . pialberta . org ). It points out that , of all the countries with universal , singlepayer health care systems , Canada is the only one that does not include comprehensive prescription drug coverage .
The paper also points out that in Canada , we pay 30 % more for pharmaceuticals than the average for other OECD countries . This is so largely because we do not utilize the advantage a single-payer system has to become a single bulkbuyer when dealing with the drug manufacturers . Research done by the Canadian Centre for Policy Alternatives has shown that if Canada were to adopt Universal Pharmacare , it could realize savings of up to $ 10.7 billion on total drug expenditures .
At its recent convention , the Canadian Medical Association called for a National Strategy on Seniors Care . To be economically viable , such a strategy needs to focus on high quality home and facility care , and on an affordable , accessible and universal pharmacare plan .
Perhaps the Alberta government needs to re-think its position before dropping the second shoe .
4 Winter 2013