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Should we replace all existing private and public drug insurance plans and set up a new government bureaucracy?

The recent report on pharmacare by Dr. Eric Hoskins and his advisory council addresses a definite need to expand drug coverage to include all Canadians. However, it avoids certain rather important issues.

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Some 10 to 20 per cent of Canadians are uninsured or underinsured for necessary prescription drugs; the rest are covered by a patchwork of public and private plans. The problem is exacerbated by the aging population and the greater number of part-time workers with few drug benefits. Drug costs are rapidly increasing, generic drug prices in Canada are the third-highest in the world. Some drugs in Canada are 10 times as expensive as in New Zealand.

Some 10 to 20 per cent of Canadians are uninsured or underinsured for necessary prescription drugs; the rest are covered by a patchwork of public and private plans.

The Hoskins report lists six “Comparator Countries.” In virtually all, health delivery is national. However, the Canadian constitution requires that health be under provincial or territorial jurisdiction. Hoskins acknowledges that it may take some time before all provinces and territories are prepared to opt in. This certainly applies to Quebec, which already has a comprehensive, universal drug plan and its own agency, INESSS, to evaluate drugs This will undermine the goal of mirroring all of the principles in the Canada Health Act.