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(photo by Benny Lin via Flickr)

Election 2015: National plan needed for Canada's aging population

Pharmacare should be part of a seniors strategy, 茄子直播 experts say

While the main political parties are shying away from an evidence-based national seniors strategy that would include a country-wide pharmacare program to pay for prescription drugs, two 茄子直播 professors are passionately advocating for a plan on behalf of older Canadians.

Dr. Samir Sinha, an assistant professor of medicine, and Dr. Danielle Martin, an assistant professor in the department of family and community medicine, are regular members of a CBC television news panel that discusses health care issues. Other members are Dr. Jacob Udell of the Faculty of Medicine and Dr. Peter Lin, who was the medical director at the Health and Wellness Centre at 茄子直播 Scarborough for seven years.

When asked on air what the most important issue is in the federal election campaign, Sinha said a national seniors strategy. Martin's choice was pharmacare. The two are intertwined.

In an interview with 茄子直播 News, Sinha explained the need for the national strategy. Martin responded via email to questions about pharmacare.

Sinha, director of geriatrics at Mount Sinai Hospital, received a grant from the Canadian Institutes of Health Research (CIHR) to examine a national seniors strategy. He is also working with the Ontario government on seniors issues.

鈥淲hen you travel around the province you quickly realize that not enough is being done to meet the needs of an aging population, and not just in health care,鈥 Sinha said. 鈥淪eniors are concerned about finances so they don鈥檛 age in poverty. They are concerned about community care, appropriate housing and transportation.鈥

Ontario is implementing many of the reforms advocated by Sinha and organizations such as the Canadian Medical Association. But what is needed is a pan-Canadian approach.

鈥淭his is not something each province can do on its own,鈥 Sinha said. 鈥淲e have to do this collectively as a country.鈥

The federal government has taken a 鈥渉ands-off鈥 approach to health care, Sinha said. Whoever forms the next government could play a significant role not only in managing the Canada Pension Plan, the Old Age Security program and the Guaranteed Income Supplement but also take a leadership role in major infrastructure projects that would benefit seniors.

Martin, vice-president of medical affairs and health systems solutions at Women鈥檚 College Hospital, said implementing a national pharmacare program 鈥渨ill require courage and some up-front investment to put in place the mechanisms to build a national formulary and engage in price negotiations with the pharmaceutical industry.鈥

She noted that a recent poll showed that one in five Canadians 鈥 either themselves or someone in their household 鈥 had not taken medications as prescribed because of the cost. 鈥淚n my practice, I see health conditions worsen over time when people do not take their medications.鈥

The federal government and the provinces could commit to establishing a single-payer system within four years, she said, along with a publicly accountable body to administer it. 鈥淚t鈥檚 completely doable.鈥

The NDP announced a $2.6-billion, four-year program in support of a transition to a national pharmacare plan on Sept. 18. The federal government鈥檚 purchasing power would be used to negotiate better prices for drugs, which could save on average 30 per cent on prescriptions.

The Liberal Party has 鈥渕ade vague statements about wanting to include pharmacare on a list of items to be negotiated with the provinces,鈥 Martin said. 鈥淭he Conservative Party has not yet articulated a policy on pharmacare, although the current minister of health [Rona Ambrose] has said the federal government would like to participate in bulk purchasing of drugs with the provinces.鈥

The latest federal budget included income splitting and allowing people to put more money in Tax Free Savings Accounts (TFSAs). 鈥淚t sounds really good politically,鈥 Sinha said of these measures, 鈥渂ut from a policy standpoint it doesn鈥檛 address the fundamental issue of poverty for older Canadians. Many of them don鈥檛 have enough money to put much in TFSAs.鈥

Sinha agrees with Martin that a new program would have to focus on 鈥渂ulk buying鈥 and the elimination of co-payments, which many seniors face when buying prescription drugs.

鈥淐o-payments do more harm than good,鈥 Sinha said. 鈥淢any seniors simply choose not to fill their prescriptions because they can鈥檛 pay even low co-payments.鈥 This in turn adds to health care costs.

One of the reports produced through the CIHR grant concludes that while older Canadians account for 15 per cent of the overall population, they account for 60 per cent of the total spending within provincial and territorial medication programs. About 40 per cent of older Canadians are taking one inappropriate medication. An additional 12 per cent take multiple inappropriate medications.

Sinha said the Liberals, the NDP and the Green Party are all generally supportive of a national seniors strategy. Nevertheless, he said, details are lacking.

鈥淲e want to be non-partisan about this,鈥 he added. 鈥淲e just want to make sure that any program is based on the evidence and good policy.鈥

Green Party Leader Elizabeth May has been the strongest advocate for a national seniors strategy, arguing that it needs to include not only a pharmacare plan but a policy to deal with dementia and Alzheimer鈥檚 and a respite program for caregivers.

In Martin鈥檚 view it is the social determinants of health 鈥 income, education, employment, housing and food security 鈥 that shape our wellbeing. 鈥淚ncome in particular determines access to all of these other determinants of health,鈥 he said. 鈥淎 commitment to reducing or ending poverty is needed federally.鈥
 

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