Health Care

[Fuzz]

Lots of chatter in the GG thread, we should discuss it here, lots of interesting topics to discuss.

Recently there was a report released regarding Pharamacare and that it could save $5 billion a year:

https://www.cbc.ca/news/politics/pha...port-1.5171517


Full report here:


https://www.canada.ca/en/health-cana...port.html#recs


Alberta at Noon did an hour show on it here:

https://podcast-a.akamaihd.net/mp3/p...C-20190613.mp3

I was totally convinced after hearing this. Every Canadian should listen to it. Scheer says we can't afford it, which is following ideology, instead of researched facts. This would save us money, and provide more stability. It's really a no-brainer, so it will never happen.

[Weitz]

I thought this was a good opinion piece about Pharmacare.

https://www.cbc.ca/news/opinion/phar...port-1.5189656

By ignoring mistakes of the past, this report appears idealistic and short-sighted. It is not the practical, long-term plan that our country needs to achieve true universal care. For that, this country needs a larger conversation about what we want from our health care system, and how much we are willing to pay for it.

[Lubicon]

Regarding universal pharmacare, I will admit I have not listened to those interviews nor do I have all the information. So maybe these questions have been answered but my two initial concerns with a universal program are:

1. the assumption that my current private plan through work will go down in price if drug costs are shifted to the taxpayer from the plan subscriber. I am skeptical of this, it has not happened with regulated dental fees so I do not have confidence it will happen with drug costs. At the end of the day I suspect my current plan cost will remain and in addition taxes will increase to pay for the universal plan. My overall cost will end up going up not down.

2. just because we could negotiate in bulk for lower drug prices does not mean drug companies will be willing to enter into contracts at those lower prices. It's possible they will elect to sell elsewhere where they can get higher prices with the result being a potential shortage and/or reduced access to new drugs or popular ones.

I'd be interested in seeing the research on these two topics.

[Fuzz]

My thoughts around item 1 is that there may need to be some intervention there. I don't know how it would take place, but lets say our taxes needed to go up 0.5% to cover it(though indications sound like it will be mostly funded without that need), then our insurance costs should go down that percentage. There would obviously be huge savings to the insurance industry(and job losses) so there is no reason they should continue to charge for something they don't provide.


For 2, ya, you should listen to the show when you have a chance, it goes into that. But the short of it is that drug companies in other countries enter into these agreements and haven't had an issue like you describe, so I don't know why it would be different for us.


On another note, I also think we should put a lot more money into government funded drug research in this country, primarily through Universities that could look at stuff that drug companies don't want to fund becuase there is no money in it for them, but would benefit society by reducing health care costs.

[Northendzone]

interesting topic for me personally, as i work with this sort of stuff.

the drug pricing scheme in canada is goofy to say th elast. drugs that cost a lot here, are very cheap in india - i amn not really sure why

secondly, this would be a massive expense for the taxpayers and has a potential to be a massive boondoggle - easy to see the implementation and delivery of this plan going sideways. from what i have seen, nobody has really contemplated how to finance this (if only we had some natural resource available to sell on the world marketplace). Also would be interesting how the feds may deliver a drug plan and province deliver the other parts of health care.

if some national plan for everyone was created, presumably your health coverage costs thru your employer or personal plan would drop - but i would ahve to think the savings would be offset with some type of tax.

Personally, i don't have much faith in the government to deliver something of this magnitude.

as mentioned in some of the articles, it would seem the first step to to try and fill in the gaps of those who currently do not have coverage.

[Fuzz]

The interview made some good points about how we already overpay through taxes. Government employee health plans, hospitals, people on financial assistance, they mentioned a large amonut of different areas where taxpayers already pay for drugs, so being able to reduce those costs would be a big savings. Could it be a boondoggle? Sure, of course. But is that a reason to not try to do it competently? They would really need to make a solid plan and have the right people.

[topfiverecords]

Not "Let's Talk About Healthcare"?

[nfotiu]

Doesn't Canada already put a lot of controls on drug prices? Thus the reason that Americans try to buy from Canadian pharmacies? It seems there wouldn't be a lot of room for savings.

[Fuzz]

http://www.cmaj.ca/content/189/23/E794.full#T2


Sorry for the really small font there...but drug expenditure per capita ranges from Canada and $824 to New Zealand at 365. This is from 2015, I believe New Zealand has even better prices now. We are the highest listed here though, so even a 25% savings doesn't seem hard to achieve.

[CaptainCrunch]

Is it a good idea? Probably though it brings up questions around people that are already covered for perscription drugs through their work or private insurance.


Is it something that the government can do without it running massively over budget or becoming a hyper inefficient boondoogle where people can't get the drugs they need . . . doubtful

[Northendzone]

these days the exchange differential would certainly help the drug pricing

Originally Posted by nfotiu

Doesn't Canada already put a lot of controls on drug prices? Thus the reason that Americans try to buy from Canadian pharmacies? It seems there wouldn't be a lot of room for savings.

[GGG]

First we need to have the hard conversation of how far to we extend human life and how much will we spend on standard of living.

The cost of health care is rising faster than inflation and population growth. This problem needs to be addressed before further expanding the government portion of healthcare.

In order for the cost to be a net benefit you some how need to recover the personal and corporate savings in the form of taxes to cover the costs of Pharmacare. This increase in taxation will be significant and unpopular despite the potential that it washes over the economy. It will also be seen as a disincentive to investment as corporate taxes will need to increase despite reducing employee costs. These are manageable issues but will slow down implementation.

I think as part of a massive overhaul of allowing more private services and private insurance and a discussion of what should a public health system cover that pharmacare would be part of the final program.

[GordonBlue]

Originally Posted by Weitz

I thought this was a good opinion piece about Pharmacare.

https://www.cbc.ca/news/opinion/phar...port-1.5189656

I can totally see the liberals latching onto it as part of an election platform.
then totally screwing up the development and implementation, making it next to useless.

[Northendzone]

Originally Posted by GordonBlue

I can totally see the liberals latching onto it as part of an election platform.
then totally screwing up the development and implementation, making it next to useless.

if the Libs do use this as a plank, i sure hope that those in the room when JT speaks to it start asking him a lot of a questions on how it will be funded.

right now it seems that Canada can't handle it's current obligations, never mind taking on new ones.

to me it seems the liberals want to push regular Canadians into a tax bracket of more than 50% (i suppose if one were to tally up all the taxes some are likely there already)

[Weitz]

Canada can't afford its current health care system IMO. A lot needs to be done prior to this.

[Fuzz]

Y'all are missing the part where this actually saves money. Saying we can't afford it is like saying we can't afford someone to hand us money for free. Seriously, listen to the podcast when you have time.

[CaptainCrunch]

Originally Posted by Fuzz

Y'all are missing the part where this actually saves money. Saying we can't afford it is like saying we can't afford someone to hand us money for free. Seriously, listen to the podcast when you have time.

We get that there's an estimated costs savings.


The questions have to be asked about basically putting together an entirely new system or bureaucracy. What are the initial setup costs for this, how many employee's is it going to require, what are the logistical costs.



What is the final tax increase per individuals or families? to run this and fund it.


Lets say that it saves a family $2 or 3 or 4 or 5 hundred a year, but the tax increase per month to the average person is $40 or $50 bucks a month, then sure there's savings on the drugs, but for the average family they pay on the tax side with reduced income after taxes.


Lets get the parties if they're going to plant this to lay all of this stuff out before we start jumping for joy, because I always have my doubts with any government that throws out a claim that it will save $5 billion bucks a year. Specfics not guesses are how this is going to be sold.


And then there's the whole question of who runs this thing, for example are the workers a required services which means no strikes? Because lets say there's a strike and drugs become unavailable?


I just have tons of questions before I declare this as a great plan.

[Fuzz]

I think a lot of your questions are already answered in the report(which I will add to the OP).


https://www.canada.ca/en/health-cana...port.html#recs


Remember you may be creating one new bureaucracy, but you will be getting rid of 30 other ones.

[Weitz]

Originally Posted by Fuzz

Y'all are missing the part where this actually saves money. Saying we can't afford it is like saying we can't afford someone to hand us money for free. Seriously, listen to the podcast when you have time.

Did you read the article I posted?

[Fuzz]

Originally Posted by Weitz

Did you read the article I posted?

The opinion piece? Ya. Not a lot of substance there, other than discussing the failure of an Ontario program, and a little jab to make it political at the end. My counter to that is that other countries have managed it successfully. We have also had 5 studies over the decades looking at pharmacare and they have all recommended we do it. I guess I have to put more weight into that than the opinions of 2 people.