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Old 06-26-2019, 03:21 PM   #21
Weitz
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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.
There are distinct differences between our system and other countries that brings added challenges. Without wholesale change saving money is a pipe dream imo.
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Old 06-26-2019, 03:24 PM   #22
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I have long thought that it is time for a second tier option to come in.

We have private Imaging already and some private surgeries (Cataracts for instance).

Last year 64,000 Canadians (including my wife) went South at great expense to help get answers. In our case there was a work up needed that required 3-4 different specialists. We were able to get all the testing done in one week, at the Mayo. While we did not get a definitive diagnosis is narrowed the search greatly.

There is nothing in Alberta that allows you to go see in an internal medicine doctor, get appointments within two weeks with Neurology, Gastroenterology, Metabolics, Infectious disease and Rheumatology and have those specialties communicate with each other about a possible diagnosis. Imaging, lab work etc could all be done too.

Two tier is the only way to go IMO. You make it so that each doctor must work a certain percentage in Public (lets say 70%) and a certain percentage in private (lets say 30%).

Create private hip replacement clinics. Knee replacement clinics etc.

Also, open it for Private insurance to pay for visits to these private clinics. Someone on Disability insurance could get a procedure done right away, rehabbed proper and be back to work long before having to wait two years for a hip replacement.
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Old 06-26-2019, 03:27 PM   #23
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Well that's what it is, wholesale change. I don't understand the resistance here. We are basically changing from a system where you pay insurance, and insurance pays your drugs, to where you pay taxes, and taxes pay for drugs. By doing this you have one system instead of thousands. You have one buyer.



Look, I could go on and on, but it is all there in the report. If you have a specific issue with what is being proposed, that's fine and worthy of discussion, but saying "it costs to much" or "it won't work in Canada" is ignoring facts and logic.
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Old 06-26-2019, 03:48 PM   #24
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As a high earning, childless, healthy male, I struggle because every time I see a statistic about "average costs going down because government!", it is code for "my cost is drastically increasing with zero benefit."

I would support it if we pay for it through a reduction in the personal exemption, or an increase in the GST. We all chip in, we all benefit. It's the Scandinavian model, which I support.

I know that won't happen though, and it'll just be a +5% tax on my bracket.
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Old 06-26-2019, 05:47 PM   #25
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Well that's what it is, wholesale change. I don't understand the resistance here. We are basically changing from a system where you pay insurance, and insurance pays your drugs, to where you pay taxes, and taxes pay for drugs. By doing this you have one system instead of thousands. You have one buyer.

Look, I could go on and on, but it is all there in the report. If you have a specific issue with what is being proposed, that's fine and worthy of discussion, but saying "it costs to much" or "it won't work in Canada" is ignoring facts and logic.
The government could deal with pricing through legislation without the whole pharmacare program. So tying the savings of this program to the action of the government isn’t a fair comparison of the two programs.

Secondly the argument of 30 bureaucracies is less efficient than one bureaucracy doesn’t really hold true in practice. Competition drives efficiency which then drives out cost. It’s why in general the government delivery of service is less efficient than private delivery when the profit motive is aligned with the product.

You can make the argument that the profit motive of insurance companies leads to worse service of consumers but it certainly won’t be less efficient.

That said I am in favour in a government funded drug system as long as competition remains to drive efficiency and strict limits on what we cover and how new drugs are added to what is covered.

In following some of the links in this thread I read that in 1985 drug costs were 3 billion now their 33 billion so again growing in cost way faster than pop growth plus inflation. So regardless of who is paying for the drugs that is not a sustainable program. Individuals make choices when faced with price pressures governments borrow to avoid controversy. So by putting the decision of what drugs to cover in the hands of government will lead to more spending on drugs then if left to employers and individuals.

Finally the costs shifts from individuals and employers to the government so since corporate taxes likely won’t go up this will be born by individual tax increases. It’s also unlikely wages increase as a result of this change. Maybe some minor price reduction and increases in competitiveness. The bulk of this increase will be made in debt and personal taxes. So it’s a savings for businesses in the end and non-insured individuals
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Old 06-27-2019, 07:41 AM   #26
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https://www.cbc.ca/news/canada/briti...191176?cmp=rss


This wouldn't happen if we had a national plan. They even mention that a few provinces negotiated lower prices but BC has not, probably becuase they don't pay for it, which means even if these people had the means, they would still pay more. End result? Suffering and death.
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Old 06-27-2019, 12:39 PM   #27
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https://www.cbc.ca/news/canada/briti...191176?cmp=rss


This wouldn't happen if we had a national plan. They even mention that a few provinces negotiated lower prices but BC has not, probably becuase they don't pay for it, which means even if these people had the means, they would still pay more. End result? Suffering and death.
It would still happen if we had a national plan unless the policy is to approve any drug at any cost. This is one of the uncomfortable conversations that needs to be had. It is just as likely that Canada would have been like the Majority of provinces and not covered than like the 4 provinces who do cover it.

Is a 40-50% improvement in the condition worth 700k in the initial year and 350k each year after. From the article it does not appear that this is a cure and that this medication would be continuous. These types of drugs will become more and more prevalent as tech advances.

Right now each province has a cost / benefit threshold. A federally administered plan will have one as well.
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Old 06-27-2019, 01:04 PM   #28
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But the provinces who do have it have negotiated a better price, which make sit more liekly to be covered. Yes, there will be some drugs they decide not to, but the point is, in Canada we currently don't have the same drugs available in all provinces. It woudl be easier to understand if it was denied in all of Canada rather than just some of it.
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