Is How We Pay for Prescription Drugs Killing Canadians?

Well, suck it up buttercups...

Canadians—by and large—view health care as a right. In that light, we do a reasonable job of ensuring that all Canadians have decent access to hospital and doctor care.

That, unfortunately, is not enough to give complete health care coverage. We fall egregiously short when it comes to prescription drugs. For some unfathomable reason, we treat this little nugget as a privilege. A privilege granted to those with a good job with benefits, and when we are generous to the very poor and the elderly.

As to the other 7,000,000 Canadians with poor—or simply no—access to drug coverage? Well, suck it up buttercups.

It is critical to recognize that when we view access to medicine as a privilege, we open the door to private insurance. And almost magically, the needs of insurance companies immediately outweigh the needs of the sick. To ensure profit (or in the case of not-for profit entities, residuals) they routinely deny health coverage to many Canadians because—from the insurance perspective—the sick are too expensive to cover.

A friend from a previous life, Joanne Spetz, at University of California of San Francisco’s Institute for Health Policy Studies recently remarked about the belief that health care is a privilege, “If you take that position to the extreme, one would have to be comfortable with letting people die on the street.”

She's right. And when it comes to prescription medicine, we Canadians are just that—comfortable.

So, is our approach to paying for prescription drugs killing Canadians?

The short answer? Yes.

Here’s why:

The paper “Association Between US Norepinephrine Shortage and Mortality Among Patients With Septic Shock,” showed that a 2011 shortage of a fairly important but basic drug led to premature death. So not having access is bad.

A second, “Did Medicare Part D reduce mortality?” looked at this issue the other way around, showing that providing drugs through a new government program reduced mortality by 2.2%. So having access is good.

And, yes, I do realize that these are US papers, but when it comes to drug coverage we have the very same system as the the US.

But what is key to note is that the directionality of both papers show the same thing: access to drugs reduces mortality.

So given this, and knowing that we have 7,000,000 Canadians who are either under or uninsured, it is rational to conclude that Canadians ARE indeed dying as a result of our patchwork drug system. A system that is predicated on accepting that access to drugs is a privilege which leans heavily on private drug insurance.

If you apply that 2.2% reduction in mortality to Canada, that means 225,000 may have needlessly died since 1966 because we “forgot” to finish the health care system—6000 in the last year alone. We have effectively killed Kitchener.

Now, the statisticians and policy folks are going out of their mind right now worried about the modelling and whether it is generalizable. I think it is since the Medicare system for senior citizens in the States, was EERILY similar to the Canadian system. That is until they added drug coverage.

But, really, the actual number is irrelevant, because you need to ask yourself a few questions:

  • How many deaths of Canadians over the last 50 years do you think is an acceptable number?
  • How many dead Canadians are you willing to accept to ensure insurance companies make money?
  • How many dollars per dead Canadian is a reasonable amount for private insurers?

Sadly we cannot do anything about the past. But shouldn’t that number be zero starting today? Shouldn’t Canadians' very lives be more important than corporate income?

Note that the video talks about 3,000,000 Canadians being under or uninsured. After recording, more research suggested that the number is much higher at about 7,000,000.