Ryan MacNeil remembers what it was like to be working a job without a health insurance plan.
He isn’t alone. An estimated one in five New Brunswickers is uninsured or underinsured, according to the provincial Department of Health.
“Every time that something would come up with the kids, whether it be an ear infection, a sinus infection, they need medication for sickness, it was $60, $70 out of our pockets,” MacNeil says. “That added up. In one year, we spent nearly $2,100.”
While he now has a job that provides medical insurance, MacNeil recalls the stress on his family.
“I had to sell my laptop at one point. I had to sell a TV just to make sure that we had everything we needed,” he says. “It’s not easy without coverage, and the problem is a lot of the jobs now are contract jobs.”
In the upcoming election, three of the four major federal parties are promising some form of a pharmacare plan for the country.
MacNeil says that while the cost of a national pharmacare program may sound large, money would still be going back into the economy with people being able to “spend that extra $60” on things like food or heat.
In June, the Advisory Council on the Implementation of National Pharmacare, created by the federal Liberal government, said a single-payer, universal program could cost $15.3 billion annually.
But it’s also widely believed that a pharmacare program would save the health-care system money in the long run.
Dr. Sarah Gander, a Saint John-based pediatrician, has spoken publicly about why she believes a pharmacare program would be part of a “more sustainable model,” particularly for people living on low incomes.
“You look at Hepatitis C, for example, it’s a large upfront cost … several thousand dollars,” she told Global News in a phone interview. “It’s six weeks of treatment, but for our children who contract Hepatitis C, that saves them two liver transplants in their lifetime.”
She says many of her patients spend anywhere between $20 and $5,000 each month on medication.
“There are definitely instances where, at the end of the day, I can’t prescribe what I feel is the best medication … and have to go to something cheaper or ‘second line’ or I know to be not as good, just because that’s what their plan can afford or maybe they can afford out of their pocket,” Dr. Gander says.
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The advisory council’s report estimates that Canadians spent $34 billion on prescription drugs in 2018. It also says three million Canadians don’t fill their prescriptions because they cannot afford the cost and another one million cut spending on food and heat to be able to pay for medication.
The Liberals have vowed to take the next steps toward a federal pharmacare plan based on the advisory council’s guidance but haven’t provided a clear timeline. The party says it will negotiate with the provinces to create its plan.
Andrew Scheer’s Conservatives have criticized the Liberals’ plan but have not made any pharmacare-related commitments. The party is promising to increase health-care transfers to the provinces.
But Mario Levesque, a Canadian politics professor at Mount Allison University in Sackville, N.B., says Canadians should be asking more questions of the federal parties about their pharmacare promises.
“The devil’s always in the details in these sorts of things,” he says. “We don’t have the details of the program, and that’s something that’s very concerning overall because we don’t know what we’re going to get. It’s like a random lottery.”
Details that need to be made more clear, he says, include whether the plans cover everyone, which drugs will be eligible and the percentage of each plan’s co-pay.
The New Brunswick Pharmacists’ Association says pharmacare is a “complex topic” and that the federal platforms don’t provide enough answers.
“I think at a high level, everyone wants to make sure we have adequate drug coverage,” says Paul Blanchard, the association’s executive director.
“The access to prescription drugs is important whether you’re not insured or you’re underinsured. Those are two elements that have to be at the beginning phase of a program. Beyond that, you’re getting into the details of what a national program should look like and who should pay, how much should they pay, what should be covered.”
Blanchard says the drug shortages that have been ramping up in recent years are also a concern.
“There are some benefits to going to a national payer, and we would expect that the costs would be lower,” he says. “But the downside of going to a single-payer is that there’s a likelihood that you’re going to lose manufacturers so then you’ll be down to just one manufacturer that makes this product, and when they aren’t able to do it, you have a shortage.”