What you Should Know About Canada’s [National] Healthcare System Today

In short, it’s Not. (National, that is.)

This week our provincial and territorial leaders have been meeting in beautiful Niagara-on-the-Lake Ontario for what is known as a “Council of the Federation” meeting. Healthcare is on the agenda today for about 30 minutes. Outside the meeting, countless advocates from all areas of healthcare were voicing concerns about recent changes to our “national” framework for healthcare. Nurses, physicians, and patient groups all have significant concerns with what has silently transpired over the past year…

 

What Happened to the Canada Health Accord?

As much as we were all HOPING to see provincial disparities addressed with a new Canada Health Accord in 2014,  late last year the Canadian Federal Government declared unilaterally that funding will be given to each province without any strings, but, *of note*, starting in 2014-14,according to a “per capita” calculation.  That may be good news for Canadians in provinces with stronger economies and younger populations. It will certainly be bad news for Canadians living in provinces with less wealth and older populations.

But Don’t We Still Have the Canada Health Act?

Yes, but the Canada Health Act was written a long time ago (50 years) and while it ensures certain healthcare rights for ALL Canadians (such as access to physician services and in-hospital care – including drugs you need IN hospital), it does not include take-home prescription medications. That’s up to the provinces (or to your private drug plan).

So What Does This Really Mean for Kidney Cancer Patients?

When a patient calls and asks about what treatments they can access under our publicly funded healthcare system, the first question has to be: “well where in Canada do you live?” Things are VERY different for Canadians living in BC compared to those in NB. In some provinces the drugs will be “free”, and in others you would have significant out-of-pocket expenses.

Imagine this scenario. You are a 45-year old patient recently diagnosed with advanced kidney cancer. Your oncologist wants you to take an oral therapy for your cancer such as Sutent or Votrient. You are self-employed and have no private drug insurance.

  • In BC, the full cost of your drug (Sutent or Votrient) will be covered by the provincial drug program – regardless of your age, regardless of your income.
  •  In ON, your age (under 65) would mean that you are not eligible for provincial drug coverage through the Ontario Public Drug Program. You could apply for Trillium coverage that would reimburse you (for approved drugs) except for a 4% co-pay on your total household income. So, assuming drug costs of $72,000 per year (Sutent and Votrient each cost approximately $6,000 per month), and a total HOUSEHOLD income of $160,000, your annual out-of-pocket cost would be $6,400. You might have had to stop working, so a net cost of $6,400 can be crippling. For information for residents of Ontario: click here.
  •  In NB, your age (under 65) would mean you are not eligible for NB Pharmacare. Worse, there is no provincial program for catastrophic drug costs, so your total out-of-pocket expense would be the full cost of the drug, $72,000 per year. We don’t meet many New Brunswickans who can afford to pay $72,000 a year without cashing in lifetime savings or re-mortgaging their home. Some simply refuse the treatment.

Is that how you thought our Canadian healthcare system was supposed to work? That we would bankrupt a cancer patient on one coast and fully pay for treatment on another?

For a listing of all provincial drug programs, see this list of references.

What Can You Do?

  1. You can let your Federal Member of Parliament know that you believe Canada needs a National Healthcare Strategy including a National Pharmacare program. The only way we will solve some of these disparities will be through a national strategy that ensures some accountability for fairness and equity for all Canadians.
  2. And, in the meantime, if you have private health insurance and you can manage to keep it or increase it somehow, remember that even once you hit that magical age of 65, you will be far better off with private coverage for diseases like kidney cancer.
  3. Stay informed about what’s happening in healthcare. As Andre Picard wrote in the Globe and Mail this week, so far there has been a “deafening silence” surrounding the absence of the Federal Government’s role in healthcare discussions. This is a significant shift for Canada and for our sense that we have a national healthcare system. Quite simply, we don’t. We have a set of 14 increasingly disparate provincial systems with no system of accountability for how each province spends the healthcare transfer.

Some recent articles:

CARP: http://www.carp.ca/2013/06/28/canada-needs-pharmacare/

Media on Council of the Federation:

http://www.ipolitics.ca/2013/07/25/health-care-rally-knocks-on-council-of-the-federations-door/

…on Social Media (see hashtags #Stand4Medicare, #cdnhealth #cof13 on Twitter) and watch your national and local newspapers for coverage this week-end and beyond.

Comments? Is this all ok with you?

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