POLS 403 Term Exam
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Term Exam Term Exam University of Northern British Columbia
POLS 403: Social & Health Policy & Admin Jason Morris
June 15, 2023
Term Exam
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#1
It has been stated many times that Canada is the only country that has universal healthcare that does not include prescription drugs in its coverage (Government of Canada, 2019). Although the thought of introducing a national drug program sounds more than ideal, there are a few hurdles to overcome first. The most obvious rationale for making any change to our system is the initial debt that would be uncured. To be able to initiate a national pharmacare plan would cost anywhere between the range of “$15 billion and $32.7 billion” (Government of Canada, 2019). As stated in 2020 Canada was in a deficit of $343 billion of the federal budget (Fraser Institute, 2020). So, the question is granted, where would this money come from? More taxes? Rolling out such a massive change would require a lengthy amount of time and money to develop job roles, bargaining with pharmaceutical companies, and legislation to name just a few.
There is also the conversation being had about the risks of over prescribing from physicians with pharamacare. As the opioid crisis has been getting an immence amount of support through recent
years to overcome this issue, having these drugs cost nothing to all can seem like an incentive to be able to prescribe more, doubling back on progress made thus far. Opioids are not the only type of drug that can pose a risk, all drugs can theoretically, but anti-biotics serve a high risk for the creation of superbugs, a bacterium that is resistant to anti-biotics. When of prescribing more anti-biotics when they aren’t needed or as a “precaution” is when this risk occurs. If the population is aware that the drugs no longer have a cost logically would mean they would be at a
clinic more often for anti-biotics as a preventative measure. Lastly, but one of the most important
reasons Canada does not have a national drug plan is the principle of freedom. To be able to enforce pharmacare the government see’s two options Universal public insurance, paid by government through taxes or statutory multi-payer insurance, where it is required by law to meet
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Term Exam the minimum health insurance set by government (Government of Canada, 2019). Both options impede on the principle of freedom. Universal public insurance takes away the choice of private insurance plan and statutory multi-payer insurance takes away the freedom to simply not take part in this area of health insurance. Granted these hurdles that must be overcome, developing such a plan has piqued the interest of 86% of Canadians (CCPA, 2020). With “one in three Canadians living with a chronic disease” (
Branchard et al., 2018) that are only continuously evolving requires new technology to find ways to treat these diseases. With new science developing to be able to extend healthy and comfortable lifespans comes with a cost and will only continue to rise. It is important to be able to provide this opportunity for all citizens of Canada thus the rationale behind the importance of a national drug program such as pharmacare. #3
Universal healthcare that represents publicly administered, comprehensive coverage, portable, and accessibility is a characteristic of Canada that citizens hold near and dear. However, when looking more closely at the state of the population actually receiving this care the scenario is much different. The waiting times are one of the largest conversations happening currently regarding our healthcare. The wait times are endless no matter the reasoning for seeking care. Need to see your general practitioner? Bookings will be at least four weeks in advance. Going to try a walk-in clinic? Better be there when the doors open. Now that’s just for the first step in the process, what if a referral is needed in order to be covered under insurance to a specialist for a surgery? The wait continues. The golden question of this topic is why is there not a firm answer on how long the wait time will actually be, or when placed on a waitlist what number they have been deemed. A rationale for this is that there is no system developed to be able to share, it is all process by hand in the surgeons’ office. The government or so those who
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oversee our healthcare system do not want to share the actuality of the problem as they know it is
a high debate topic and cautious of the negative reactions that would come of it. If there were to be a more streamline process to any physician in the field required rather than a particular one, it would create a larger access point to receiving care (CCPA, 2005). Building from that if all the physicians agreed, a software program could be developed for an online live waitlist timing so that patients can have a better idea of when to prepare for surgery. This in turn would reduce secondary symptoms of stress and other physiological repercussions of the luminous unknown waiting period. Another reason for not having comprehensive data source for wait times is the lack of outpatient or short-stay surgical centres to be able to work through the waitlist effectively
(CCPA, 2005). To receive a surgery generally means to have a hospital admission. If there were centres put in place for the most in demand of surgeries that could be sent home with education resources or a single night stay this would filter through the waitlists much faster. For example, hip and knee surgery one of the highest in demand surgeries, does not require many needs from the hospital post-op it is solely based around ambulation, why couldn’t a person do this at home?
As it stands now without a bed for the patient to be in post-op the surgery cannot happen. Although this would require funding to gain interest of surgeons and facility property it would be
largely beneficial for the health of the Canadian population and healthcare system. #5
Currently that status of our healthcare received in Canada is roughly 70% publicly administered (POLS 403, Public vs Private), that leaves the other 30% for the private sector. Within that 70% it includes all visits to clinics and hospitals encompassing all necessary testing that is deemed required during. While in the hospital it also includes all pharmacy needs, social work, physiotherapy, occupational therapists and of course surgery. However, all the care that
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Term Exam you required from the interdisciplinary teams in the hospital is no longer covered upon discharge. That is where the private sector comes into place in healthcare. In the community any elective health needs such as dentistry, pharmaceuticals, chiropractors, naturopathy, the list goes on, must be covered under medical insurance or out of pocket to be received. Now that seems like a long list to be under private healthcare when Canada represents themselves as “free healthcare for all”. The private sector plays an important role as it is largely care that is non-
emergent but rather beneficial when needed to maintain a healthy lifestyle. This means that taxpayers are not contributing to the massage therapy that their neighbor receives bi-weekly. Currently the private sector has control over pharmaceuticals which can be argued to be an emergent form of healthcare needed as without the medications patient status could severely decline leading to death. It is also a note that with it being publicly funded cost would reduce with bargaining between the pharmacy companies selling and government. This is an area that should be transitioned out of private and into public. In another aspect the public system could learn from how the private sector is currently functioning with day-surgery patients which allows
more people to be seen in a shorter period of time. As of right now if you have the means to pay for surgery you could skip the enormous public waitlist with a private surgeon. But that doesn’t seem all that fair or equal in the eyes of most as generally those who need the care the utmost are
those who do not have thousands of dollars to spend at any given time. For what Canada represents, equality and fairness, the private sector slightly diminishes these pillars. The private healthcare sector should continue to focus on non-emergent or required care for the population. Thus, leaving more opportunity for the country to grow in public healthcare by replicating what the private sector is doing while still remaining equality for all. Although in reality this will
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never fully be in effect due to the back log of the healthcare system it does pose good food for thought on how one day it can be achievable, truly giving Canada universal healthcare for all.
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Term Exam References
Branchard, B., Deb-Rinker, P., Dubois, A., Lapointe, P., O'Donnell, S., Pelletier, L., & Williams,
G. (2018). At-a-glance - How Healthy are Canadians? A brief update. Aperçu - Quel est l’état de santé des Canadiens? Brève mise à jour.
Health promotion and chronic disease prevention in Canada : research, policy and practice
,
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(10), 385–387. https://doi.org/10.24095/hpcdp.38.10.05
Fraser Institute. (2020). National pharmacare will be very expensive and likely unnecessary. Retreieved from: https://www.fraserinstitute.org/article/national-pharmacare-will-be-very-
expensive-and-likely-unnecessary
Government of Canada. (2019). A Prescription for Canada: Achieving Pharmacare for all. Final Report of the Advisory Council on the Implementation of National Pharmacare. Retrieved from: https://www.canada.ca/content/dam/hc-sc/images/corporate/about-health-canada/public-
engagement/external-advisory-bodies/implementation-national-pharmacare/final-report/final-
report.pdf
Lexchin, J. (2020). Pharma versus pharmacare. Corporate lobbyists and right-wing think-tanks are waging a war against the plan for national prescription drug coverage. Canadian Centre for Policy Alternatives. Retrieved from: https://policyalternatives.ca/publications/monitor/pharma-
versuspharmacare#:~:text=An%20Angus%20Reid%20poll%20published,were%20in%20favour
%20of%20pharmacare
. Morris, J. (2022). Public vs. Private Lesson. Social & Health Policy & Admin
. University of Northern British Columbia.
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Rachlis, M. (2005). Public Solutions to Health Care Waitlists. Canadian Centre for Policy Alternatives. Retrieved from: https://healthpols.files.wordpress.com/2016/08/ccpa-
health_care_waitlists.pdf