More On Pharmacare

The other day I wrote about an article in the Globe that called into question support for the notion of a national pharmacare program that would see drugs paid for by the government as a fitting and necessary complement to our universal healthcare. I examined the methodology and bias involved in the author's claims that people are not really keen on such a program.

In my view, what 'the people' want is rarely a consideration in public policy-making, unless there are crass political gains to be made. It is one of the reasons I like to read letters to the editor, which offer a more direct insight into people's views on issues. I am therefore reproducing three letters from today's Star on the topic of national drug coverage, two of which support the notions for economic, social and reasons:

Pharmacare to fill the gap, Editorial July 19

The demand for a national plan covering prescription drug costs in Canada has now turned into a flood – with our citizens’ backing for the pharmacare concept rising to over 90 per cent.

Studies published in leading journals indicate that medications save lives by keeping people healthy and that Canada would be saving around $9 billion annually by instituting a national pharmacare plan covering prescription drugs costs – and resorting to logical initiatives such as bulk-buying of drugs.

Despite the weight of evidence, and the push provided by provinces such as Ontario, bold federal leadership in this area has been lacking thus far. We are the only country globally that does not cover the cost of prescription medicine despite Canada’s well established and very successful universal health care system.

It is hoped that the upcoming federal elections will spur heated debates about the need for pharmacare to cover the cost of prescription medicine for Canadians, leading to healthy outcomes for patients and taxpayers alike.

It is time for our federal government to get started – as the key to success in this key health-care area is staring in Canada’s face. Stephen Harper would do well to heed Mark Twain’s sage advice: “The secret of getting ahead is getting started.”

Rudy Fernandes, Mississauga

Surely this study could have picked a better example than Lipitor at “more than $811 a year.” Generic forms of Lipitor and other statin drugs have been available for several years at about $125 for a year’s supply.

If this misrepresentation is the best example that the Pharmacare2020 study can find, what are we to make of the rest of its conclusions? If in fact there are further bulk discounts available, it would be best accomplished through provincial cooperation in the buying process, not by introducing another wasteful level of bureaucracy at the federal level.

This is just another veiled attempt to shake more dollars out of the federal government for something that is the responsibility of the provinces – the delivery of health care services.

Don Mustill, Markham

Thanks for drawing attention to yet another well researched study, Pharmacare 2020, that demonstrates that a national pharmacare plan covering drug costs for all Canadians is not only sorely needed but is economically feasible. All that remains is political will.

Perhaps if we all asked candidates who come knocking on our doors in the coming federal election what their party will do for the millions of Canadians who do not have their prescriptions dispensed for financial reasons, the message might get through.

Bill Wensley, Cobourg

Harper Under Seige

Once more, editorial cartoonist Graeme MacKay scores a solid bullseye.



As does Corrigan over at The Star:



And let's not forget Star readers:

Since the post-2008 Great Recession, Stephen Harper’s primary focus on energy (oil/gas) economic action strategies have painted our economic flexibilities into a corner. Now we find our transnational economic drivers near exhausted.

Interest rates are now .05 per cent. We are on the precipice of falling financially/economically into quicksand recessionary territory.

In hindsight, consider what if we had developed multi-faceted strategies for dynamic, clean-energy manufacturing 21st century technologies in critical mass in construction, science, industry and commerce? Would we be so constrained now with lowest possible oil/gas commodity prices? Would our “loonie” be so vulnerable? Would our frivolousness with tax dollars tied to ineffective foreign policies be so committed to 20th century industrial, free market strategic imbecilities?

Harper’s single-minded chess tactics with much of what he mismanages is fast becoming an economically unmanoeuvreable position now on a precarious global stage. And now with Iran’s economic sanctions lifting as result of the deal with the Western powers, there’s no promise of recovery ever being tied to those “triple-digit” commodity prices that Canada’s oil producers followed our PM so recklessly on.

Brian McLaughlin, Saint John, NB

I’ll have to agree with Mr. Goodale’s take on Harper’s economic record. What’s Mr. Harper’s experience in economics, again? None in the private sector that I could find. I think Canadians know who is really in over their head.

Geoffrey Allen, Markham

And one more reminder from MacKay of Mr. Harper's fiscal ineptitude:

A Tale To Frighten Children (And Uninformed Canadians)

Well, the Globe and Mail is up to its usual agenda of promoting the neocon vision. Not content to let Canadians ruminate on ideas unimpeded by thinly-disguised corporate ideology and scaremongering, it is attempting to sow doubt about a plan that would potentially benefit all Canadians, national pharmacare, whose time has surely come.

For a small primer on the concept, you could check out a post I wrote about two years ago, or conduct a Google search, which will yield some compelling links, including this one:

Canada is the only industrialized country with universal health insurance that does not offer universal prescription drug coverage, and statistics show one in 10 Canadians cannot afford to pay for their medications.

From an economic viewpoint, there is a compelling case to be made for pharmacare. Consider this report, entitled Pharmacare 2020 — The Future of Drug Coverage in Canada, an analysis of which conducted by The Star yielded these conclusions:

Not only would a national pharmacare program ensure that all Canadians have access to drugs they need, it would save billions of dollars. Authored by six health policy experts, the study was published by the Pharmaceutical Policy Research Collaboration at the University of British Columbia.

Pharmacare is the answer. Potential savings from bulk-buying through a single system are substantial. The study’s authors cited the example of Lipitor. A year’s supply of this brand name cholesterol-lowering drug costs at least $811 in Canada, according to the report. In New Zealand, where a public authority negotiates prices for the entire country, it’s $15. “In terms of drug prices, Canada’s multi-payer system is among the most expensive in the world,” they conclude.

Because the arguments in favour of a universal drug plan are compelling, and because it is enjoying a certain momentum, the reactionary right is now starting a smear campaign to undermine enthusiasm, one based on manipulative polling, lies, and half-truths.

Entitled The risks that come with a national pharmacare program, the author of this Globe article, Yanick Labrie (more about him shortly), refers to a recent Angus Reid poll which

found that 91 per cent of Canadians support “the concept of a national ‘pharmacare’ in Canada, that would provide universal access to prescription drugs ...” But they may not be ready to pick up the tab. The survey also found that 70 per cent are against increasing the GST to 6 per cent – from the current 5 per cent – to pay for the program. If you’re not willing to pay for something you want, that may be a sign you don’t really want it that badly.

What Labrie omits here is also the finding that the majority would prefer that it be paid through an increase in corporate taxes, a not unreasonable preference, in my view.

Next, the writer warns of what we might be giving up if we embrace pharmacare:

Canadians should be wary of replacing our mixed system with something like what exists in the U.K. or New Zealand. Socializing a larger part of drug spending through a single-payer pharmacare plan would give more power to government and its bureaucrats to make decisions on behalf of the insured. Policies that restrict access to new medicines would be applied across the board and would penalize all Canadians in the same way.

The implication that this would be tantamount to allowing a 'death-panel' bureaucrat to determine your fate is clearly there. What Labrie doesn't mention is that the decisions on adding new drugs to provincial drug formularies are already made for costly drugs, most of which are not covered by private plans anyway. The case of the cystic fibrosis drug Kalydeco is instructional in this regard. The final decision in that case saw Ontario deciding to fund it.

The above also demonstrates a strategy commonly used by the right: absolutism. There is nothing in any concept of pharmacare that I have ever read that would preclude any of us from still carrying private insurance. Yet read the following assertion by Labrie:

According to a recent online survey conducted by Abacus Data for the Canadian Pharmacists Association, 80 per cent of respondents support the idea of a national prescription-drug program. But only 31 per cent favour replacing our current mixed public-private systems, managed by the provinces, with a national, government-run pharmacare monopoly.

Monopoly? Who said anything about a monopoly? As well, take a look at the Abacus online survey he refers to.

A patently manipulative push poll commissioned by pharmacists, consider the biases built into the following questions:

While many Canadians want enhanced access to medications, many Canadians are also concerned about the cost of a national pharmacare program, losing their private drug plans, and the ability of governments to administrate drug plans effectively.

Which approach to pharmacare comes closest to your view?

The result?

Overall, a plurality of Canadians believed that pharmacare should only cover those Canadians who are not currently covered through some other existing government or private plan.

Here's another:

To what extent are you concerned about the following issues related to a national pharmacare program?

Replacing your current private prescription drug plan with a public plan that would have fewer choices

Increased cost to governments if patients use more prescription drugs than they do now

The ability of governments to administer the plan efficiently and effectively

The result?

Although Canadians were supportive of the proposed national pharmacare plan, most said they would be concerned if a national pharmacare program replaced their current plan with a public plan that had fewer options, if it increased costs to governments because patients use more prescription drugs than they do now, and of the ability of governments to administer the plan efficiently and effectively.

I could go on, but I would encourage you to visit the poll results to see more of the questions asked that guarantee the results the pharmacists sought.

I promised at the start that I would say more about the author of this article, Yanick Labrie, who is described as an economist at the Montreal Economic Institute. A visit to the website will tell you all you need to know about its ideological and economic leanings, as will as a list of present and former executive members, which includes former Harper favourite Maxime Bernier and right-wing commentator and analyst Tasha Kheiriddin. The vice president is currently Jasmin Guénette, former director of public affairs who came back after spending two years at the Institute for Humane Studies in Virginia, an organization that can most charitably be described as an American libertarian outfit.

By all means, let us have a national debate about pharmacare. But let it be an honest one that leaves aside the demagoguery and distortions that currently abound on this issue.

The Harper Regime In One Easy-To-Understand Graphic!

H/t Boycott The Harper Conservatives

For those of you who are more text-oriented or want a comprehensive recounting of the depredations of the Harper years, I encourage you to check out and bookmark Rural's Harper History Series over at Democracy Under Fire.

Rural has taken on the unenviable and herculean but noble task of compiling the myriad abuses of and acts of contempt against democracy during King Stephen's reign; it is a lot to take in and can be depressing at times to see what we have lost, but if read in measured amounts is a very useful reminder of why it is paramount that we toss out this band of renegades in October.

I encourage you to visit his series regularly as we head into the election, and share with those who you think might benefit.

Harper's Fingerprints Are All Over This One

It is surely a mark of the times in which we live that a climate of fear, suspicion and mistrust permeates the ranks of those who work for the federal government. Stories abound of the muzzling of scientists, the termination of employees, the closing of research facilities. Having just completed Mark Bourrie's Kill The Messenger, an excoriating analysis of the Harper regime's vindictive and paranoid nature, there is no doubt in my mind that those stories are true, leading to the inevitable conclusion that freedom of expression is one of far too many democratic rights that have suffered tremendously under this government.

The recent termination of a Parks Canada employee, a smoking gun if there ever was one, offers ample illustration. Dr. John Wilmshurst, the science and resource conservation manager for Jasper National Park, was fired on June 11.

Mystery surrounds his termination, as no one will speak out, but the likely answer is found in something that happened last year.

In a 2014 story produced by the Canadian Press and picked up by the CBC, Huffington Post, McLean’s, and other major news outlets, Wilmshurst described research he and his colleagues were doing on the melting Athabasca Glacier. He predicted that the ice could be gone in his children’s lifetime, a statement supported by recently-published research out of the University of British Columbia.

“The information that we’re getting is pretty clear that climate is warming,” he told the camera. “[Climate change] is definitely something that’s happening and it’s happening because of our activities.”

You can see the 'error' Wilmshurst made here. He drew the clear and irrefutable connection between climate change and human activity, something that is anathema in Harperland, something that is deemed seditious in our imperiled democracy. Had he followed the expected protocol of applying for permission to speak to the media, a laboursome process that more often than not results in refusal, Wilmshurst pointed observations would not have seen the light of day. Here are a few cases that illustrate the roadblocks government scientists face:

In 2010, Natural Resources Canada scientist Scott Dallimore was not allowed to talk about research into a flood in northern Canada 13,000 years ago without getting pre-approval from political staff in the office of then-Natural Resources minister Christian Paradis. Postmedia News said requests were only approved after reporters' deadlines had already passed.

In 2011, Department of Fisheries and Oceans scientist Kristina Miller was blocked from speaking to the media about her research suggesting viral infections may be linked to higher salmon mortality.

Environment Canada's media office granted no interviews after a team published a paper in 2011 concluding that a 2 degree C increase in global temperatures may be unavoidable by 2100.

Postmedia science reporter Margaret Munro requested data from radiation monitors run by Health Canada following the earthquake and nuclear plant problems in Japan. Munro said Health Canada would not approve an interview with one of its experts responsible for the detectors.

Unquestioning 'loyalty' to the regime is the only thing that matters, no matter how competent and respected individuals may be. The messages taped on Wilmshurst's former office door convey the sense of a man deeply respected and sorely missed:

“Best manager I’ve had in 33 years,” one note read.

“A source of inspiration,” said another. “Still our Chief.”

“Forever our leader.”

Such sentiments account for nothing in Harper's poisoned kingdom, and for that reason, Canada needs a powerful purgative; if we don't administer the necessary tough medicine in October, I fear all will be lost for the country that I have known and loved my entire life.

Harper Edges Closer To His Goal

That goal would be the destruction of the CBC, an ideological (i.e., publicly-funded) and political (Terry Milewski's fearless journalism) thorn in Dear Leader's side.

A Senate committee that spent 18 months studying the CBC and its place in the media landscape is recommending the public broadcaster explore alternative funding models, shake up its governance structure, be more transparent in its operations and air more amateur sports and high-quality arts.

A closer examination reveals that it is, in fact, a blueprint for eradicating the public broadcaster:

The senators, who travelled to England to study the BBC’s funding models and programming strategy, suggested a so-called “external superfund” be created by setting aside a portion of the CBC’s funding to pay for Canadian content “such as Canadian history and nature documentaries and high-quality comedy and drama, which could then be broadcast on CBC/Radio-Canada.”

The Friends of Canadian Broadcasting watchdog group called that proposal part of “a thinly disguised cut to CBC’s parliamentary grant that could never be implemented without a major contraction of the services that our national public broadcaster offers to Canadians every day.”

But it doesn't stop there. Another Trojan horse lurks in the report:

The Senate’s communications committee is also calling on the Canadian Broadcasting Corp. to find new ways to fund its operations in order to limit the amount of funding it receives from the federal government.

The committee rejected the idea of stable, multi-year funding for the Crown corporation, saying funding is based on “the fiscal demands of the federal government.”

Senators raised the possibility of using the PBS funding model — where viewers donate money or pay for sponsorships of programs — or charging a license fee to every home in the country with a television, which is how the BBC receives some of its funds.

“Even though it’s more subtle, this is proposing to cut CBC’s budget,” said Ian Morrison of the advocacy group Friends of Canadian Broadcasting.

To further erode public confidence in the broadcaster, the report seeks to sow dissension:

There were also testy exchanges between senators and CBC president Hubert Lacroix during his two appearances before the committee, and threats the committee would use its parliamentary powers to force the CBC to hand over the salaries of Mansbridge and others.

And lest we forget,

The Senate report also refers to scandals involving former radio host Jian Ghomeshi and business correspondent Amanda Lang in calling for stricter policies to prevent problems rather than having to react when they become public.

Senator Art Eggleton, whose recommendations were not included in the report, calls the report a missed opportunity,

blaming Conservative senators for spending “too much time denouncing the CBC and not enough on a way forward.”

Sen. Art Eggleton rejected some of the recommendations and says the government should increase funding to the CBC by almost one-fifth.

Eggleton said the government should spend about $40 per capita on the CBC, above the $33 per capita the report notes the broadcaster received in 2011, which would be half of what other industrialized nations spend on their public broadcaster.

He also said the funding should be adjusted to inflation and help the CBC eliminate commercial advertising.

The CBC itself weighed in, expressing its disappointment with the report:

"Frankly, we were hoping for more," said spokeswoman Alexandra Fortier, manager of media relations and issues management.

"CBC/Radio-Canada provided senators with detailed information on audience patterns, broadcasting trends, budgets, and strategies for addressing the challenges of the future," Fortier said. "It explained what it does to maximize the efficiency of its operations, and its accountability to Canadians."

"This report fails to propose constructive suggestions to address any of the real challenges facing the broadcasting system," said Fortier, who until a few months ago worked as the director of communications to Conservative minister Jason Kenney.

I suspect many Canadians will share the public broadcaster's disappointment.

Anon Poses Some Questions

I received the following as a comment in my previous post, but decided to feature it here, as I suspect the writer would like readers to offer their answers to the questions posed:

I have two questions and an observation:

I do not understand the statement that the Child Tax Benefit, benefits the rich more than the rest of us. For example, in families with a three old child, do the families not receive the same amount regardless of their income bracket? Is it because the benefit is tax free and there is no claw back?

I would like to understand why it is that when a private citizen has a mortgage taken out or the purchase of goods is made using their stolen identity, the police do nothing and say it is a private or a financial matter between the citizen and the bank or credit company.

Ashley Madison has its client accounts stolen and Anonymous threatens to reveal the names if they do not cease to operate. The police begin an immediate investigation. Is it because of the threatened demise of the legal corporate entity or do the clients have more political power or sway over the police?

Please "Square the Corners" for me.

Those are good questions, Anon, but I think I can answer the first one. A story in today's Star reveals that the child benefit payments are taxable and will, in fact, be clawed back from many of the recipients:

The benefit is taxable on the lower income earner in every household. Canadians who received the payments can expect to see some of it taxed next April unless their income is so low that they don’t pay income taxes.

Of course, that begs the question of why the cheques are being sent out to everyone who has applied, no matter their income level. The answer, I fear, is too obvious - to get the most political bang for the buck three months from the election. Says David Macdonald, senior economist at the Canadian Centre for Policy Alternatives:

“You get a cheque and it’s tangible. You have no idea what you’re going to pay back at the end of the year”.

At the end of the year - well after the election.

I invite readers to weigh in here.