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Price of cauliflower being shipped up from Az. probably, but not the healthcare.
Remember? We were talking about healthcare cratering?
As am I discussing healthcare. I don't believe the system is "cratering", as it is carefully managed from a fiscal perspective.
The level of services provided vary from province to province. The medication my relative needed (a standard drug) was not provided in BC as part of its provincial drug plan, so she had to pay out of pocket a significant % of her monthly income. She does not have private insurance which is part of the problem. BC has also been increasing its wait times and cutting services.
When she moved to Alberta, it was clear that that the provincial health care system there was more generous. Her medication WAS covered. Alberta can be this generous, just as it has no sales tax, because of its oil revenue. The NDP budget seems to protect health care spending this year, but for the first time in Alberta's history it will be issuing debt to cover day-to-day spending.
A cut in services does not equate to "cratering". However, non-acute health problems in Canada can be frustrating for people who have to wait months for an appointment.
As am I discussing healthcare. I don't believe the system is "cratering", as it is carefully managed from a fiscal perspective.
The level of services provided vary from province to province. The medication my relative needed (a standard drug) was not provided in BC as part of its provincial drug plan, so she had to pay out of pocket a significant % of her monthly income. She does not have private insurance which is part of the problem. BC has also been increasing its wait times and cutting services.
When she moved to Alberta, it was clear that that the provincial health care system there was more generous. Her medication WAS covered. Alberta can be this generous, just as it has no sales tax, because of its oil revenue. The NDP budget seems to protect health care spending this year, but for the first time in Alberta's history it will be issuing debt to cover day-to-day spending.
A cut in services does not equate to "cratering". However, non-acute health problems in Canada can be frustrating for people who have to wait months for an appointment.
I would be very interested in that particular drug that you paraphrase as "standard" but not covered in B.C. that would also be of a cost so as to equate to a significant % of anyone's monthly income.
My understanding is; the compendium of drug coverage from province to province is one of the things they try to parallel as close as possible With B.C.'s being one of the most comprehensive of all. They do this for just the reason you stipulate; to prevent the necessity of someone moving to obtain and thereby transfer a cost from one province to another's healthcare budget.
Notwithstanding the coverage aspect; B.C. has any number of pharmacare plans available I'm sure that one of which would have covered the prescribed drug. I'm fairly certain of this, if as you say, the drug IS covered in Alberta.
I don't know the specifics and it's probably not appropriate for me to pry, but it is a medication for MS. As she's on a very limited retirement income and living in subsidized housing I can imagine that anything more than $100 a month would be a significant percentage. She was previously on Vancouver Island if that makes any difference.
My understanding about BC from several sources is that they have been managing health care costs very tightly to keep increases to a minimum. It wouldn't surprise me that for expensive medication they also make patients jump through hoops by making it not approved as a "first line" medication, or recommending against it if there are no generics available.
I agree with you that the formularies should be the same from province-to-province, but I only know what I've been told.
I would be very interested in that particular drug that you paraphrase as "standard" but not covered in B.C. that would also be of a cost so as to equate to a significant % of anyone's monthly income.
My understanding is; the compendium of drug coverage from province to province is one of the things they try to parallel as close as possible With B.C.'s being one of the most comprehensive of all. They do this for just the reason you stipulate; to prevent the necessity of someone moving to obtain and thereby transfer a cost from one province to another's healthcare budget.
Notwithstanding the coverage aspect; B.C. has any number of pharmacare plans available I'm sure that one of which would have covered the prescribed drug. I'm fairly certain of this, if as you say, the drug IS covered in Alberta.
You'd be mistaken, drug coverage plans between the provinces differ significantly, with some like BC and Quebec being quite extensive and some like New Brunswick covering little. The major constant between all provinces is insurance for "catastrophic" drug expenses, so when costs for medications in a given year exceed a certain maximum, like 5000$, the government begins paying all or most of the price of approved medications. There's also huge formulary differences from province to province, with provinces continually cutting deals with different drug companies (or not) chasing after the best prices. Since they do not cooperate on drug negotiations at all you get very significant differences in what drugs are covered.
Quote:
Originally Posted by markjames68
I don't know the specifics and it's probably not appropriate for me to pry, but it is a medication for MS. As she's on a very limited retirement income and living in subsidized housing I can imagine that anything more than $100 a month would be a significant percentage. She was previously on Vancouver Island if that makes any difference.
My understanding about BC from several sources is that they have been managing health care costs very tightly to keep increases to a minimum. It wouldn't surprise me that for expensive medication they also make patients jump through hoops by making it not approved as a "first line" medication, or recommending against it if there are no generics available.
I agree with you that the formularies should be the same from province-to-province, but I only know what I've been told.
There are indeed many medications that are not a benefit under pharmacare. It sounds like she's on one of those, and for it to be covered she'd have to meet specific criteria and her doctor would then have to fill out and fax a Special Authority form to pharmacare for coverage, which is only good for 6 months until it needs to be resubmitted. It's possible she doesn't qualify, or it's a particular MS drug that I'm thinking of that's very expensive and is supposed to lead to a small improvement in quality of life based on one study that's been refuted by some others, and that the government generally doesn't want to pay for. But yeah, special authority is a pain in the ass to get, but it's still better then most of the private insurers, who also have their own parallel special authority procedures and are significantly more bureaucratic and stingy in my own experience.
The major constant between all provinces is insurance for "catastrophic" drug expanses, so when costs for medications in a given year exceed a certain maximum, like 5000$, the government begins all or most of the price of approved medications.
There are exceptions. For example, chemo given in a hospital setting is free, no matter what one's income is, as are some cancer related drugs taken at home.
You'd be mistaken, drug coverage plans between the provinces differ significantly, with some like BC and Quebec being quite extensive and some like New Brunswick covering little. The major constant between all provinces is insurance for "catastrophic" drug expenses, so when costs for medications in a given year exceed a certain maximum, like 5000$, the government begins paying all or most of the price of approved medications. There's also huge formulary differences from province to province, with provinces continually cutting deals with different drug companies (or not) chasing after the best prices. Since they do not cooperate on drug negotiations at all you get very significant differences in what drugs are covered.
There are indeed many medications that are not a benefit under pharmacare. It sounds like she's on one of those, and for it to be covered she'd have to meet specific criteria and her doctor would then have to fill out and fax a Special Authority form to pharmacare for coverage, which is only good for 6 months until it needs to be resubmitted. It's possible she doesn't qualify, or it's a particular MS drug that I'm thinking of that's very expensive and is supposed to lead to a small improvement in quality of life based on one study that's been refuted by some others, and that the government generally doesn't want to pay for. But yeah, special authority is a pain in the ass to get, but it's still better then most of the private insurers, who also have their own parallel special authority procedures and are significantly more bureaucratic and stingy in my own experience.
So that would then NOT be considered a "standard" drug as surmised by the poster?
Huh? Don't you talk to your wife/husband/partner? Especially is he or she is Canadian, didn't you ever ask, "So how does that Canadian socialized healthcare work anyway?
I sure asked my American ex-wife, who worked in the US health care field before moving to Canada. She moved to Canada to get away from all the US private-care BS and insurance and paperwork, and so on and so on. She loved it here, and remains here in Canada, even though we broke up.
You claimed that the Canadian Medical Association was an agency of the Canadian government--and you were wrong. That's what started this discussion.
I don't care about the data. That's another discussion--hell, in fact, I'll grant you that the Canadian system has a lot of room for improvement. How it can improve is another discussion.
No, what bothered me was that you said that the CMA was a Canadian government agency. You were incorrect in that assertion. But, how many American posters in P&OC did you influence with that assertion? One? Ten? A hundred? More than that? Is that your goal: to turn Americans against a UK NHS, or a Canadian single-payer system by claiming independent, non-governmental associations are government? Your feelings are your own, but IMHO, you should not claim that a professional association, in which membership is optional, is somehow government.
You're better than that, obviously.
You're correct: I don't really feel like having this discussion. It has no point: you will continue to quote stats as to how Canadian healthcare is sub-par in your opinion, and I (and fellow Canadians) can continue to discuss how it beats the US system any day, in our opinions.
Angry? Maybe. I tend to get angry when a foreigner asserts something about my country that I know not to be true.
My temperament? I'm pretty sure that my fellow Canadians on this forum will tell you that I'm one of the most level-headed, balanced, and fair posters here.
I don't know the specifics and it's probably not appropriate for me to pry, but it is a medication for MS. As she's on a very limited retirement income and living in subsidized housing I can imagine that anything more than $100 a month would be a significant percentage. She was previously on Vancouver Island if that makes any difference.
My understanding about BC from several sources is that they have been managing health care costs very tightly to keep increases to a minimum. It wouldn't surprise me that for expensive medication they also make patients jump through hoops by making it not approved as a "first line" medication, or recommending against it if there are no generics available.
I agree with you that the formularies should be the same from province-to-province, but I only know what I've been told.
...and that is what makes discussion about the Canadian Healthcare system frustrating. The people criticizing or passing along 2nd and 3rd hand stories, never have the specifics. That is how myths and misinformation starts and is passed along.
This is what makes your story seem " untrustworthy ". In B.C. we have Pharmacare. Part of our coverage to help with prescription drugs, and medical supplies.
Someone, like the case you're posting would be on Fair Pharmacare, which is an INCOME BASED plan. No extra cost, they just have to register.
"PharmaCare provides coverage of eligible prescription drugs and medical supplies through several drug plans. The largest is the income-based Fair PharmaCare plan."
"Haven't registered yet? Coverage begins immediately if you register by phone or online. There is no charge to register and there are no premiums to pay." Imagine that happening with private insurance !!!
So unless the drug is not an approved drug federally, they can't deny here an approved drug if her doctor has prescribed it. The government is not permitted to interfere with a doctors legal wishes.
...and that is what makes discussion about the Canadian Healthcare system frustrating. The people criticizing or passing along 2nd and 3rd hand stories, never have the specifics. That is how myths and misinformation starts and is passed along.
This is what makes your story seem " untrustworthy ". In B.C. we have Pharmacare. Part of our coverage to help with prescription drugs, and medical supplies.
Someone, like the case you're posting would be on Fair Pharmacare, which is an INCOME BASED plan. No extra cost, they just have to register.
"PharmaCare provides coverage of eligible prescription drugs and medical supplies through several drug plans. The largest is the income-based Fair PharmaCare plan."
"Haven't registered yet? Coverage begins immediately if you register by phone or online. There is no charge to register and there are no premiums to pay." Imagine that happening with private insurance !!!
So unless the drug is not an approved drug federally, they can't deny here an approved drug if her doctor has prescribed it. The government is not permitted to interfere with a doctors legal wishes.
I suspect she isn't telling you the whole story.
Quite possibly she's mistaken. Or as another poster mentions, it's a drug with little benefit. Or the doctor isn't telling her the whole story. Or she's not aware of what her rights and privileges are.
So unless the drug is not an approved drug federally, they can't deny here an approved drug if her doctor has prescribed it. The government is not permitted to interfere with a doctors legal wishes.
There is a particular drug I'm interested in which was approved by the FDA in November after clinical trials. Health Canada is reviewing the drug now for approval in Canada. If approved, it will mean that it can be legally prescribed in Canada. Whether the drug will be paid for by Pharmacare however is up to the individual provinces. In other words, Health Canada's role seems simply to assess safety.
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