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Decentralized Democracy

House Hansard - 300

44th Parl. 1st Sess.
April 16, 2024 10:00AM
  • Apr/16/24 11:13:04 a.m.
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Madam Speaker, there is no denying that Quebeckers’ interests are absolutely the same as those of everyone else in the country. Everyone wants access to a health care system that works properly for all. As for the questions surrounding drug insurance, I have had some really good conversations with Minister Dubé in Quebec. There is a clear spirit of co-operation. If one goes looking for a fight or problems, they are easy to find, but the idea is to find solutions and a way to work together to resolve the situation, to improve people’s health across the country. For example, it is absolutely essential that we take into account the indicators for Quebeckers, so that we can compare and contrast how things evolve in their system and how they evolve in the other provinces and territories. This is a very good thing to do, and it is also good to see where the federal money is in the plan. That is why it is more important to co-operate than to pick a fight.
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  • Apr/16/24 1:57:40 p.m.
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Madam Speaker, I listened to the speech of my colleague with great interest, and I know he is a great advocate for health care for Canadians. I would like to ask him about the situation in Quebec. Maybe he is not that familiar with it, but we did hear how many unions are in favour of our health care plan, even if their members have employer drug insurance.
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  • Apr/16/24 3:41:26 p.m.
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Under-insurance can take many forms. For example, Canadians may have high deductibles, resulting in significant out-of-pocket costs before their insurance coverage even kicks in; they may reach the maximum annual or lifetime coverage limits for their insurance and have to pay out-of-pocket; or they may have high co-payments, which are often more than 20% of the drug's cost on private plans and sometimes more on public plans. All provinces have drug coverage to protect Canadians from catastrophic drug costs, but deductibles under these plans can range from 0% to 20% of net family income. In many cases, Canadians will never reach the deductible, leaving them without any support for their drug costs. This variability across the country creates a postal code lottery. We can again consider the advancements in diabetes treatments. For a working-age Canadian with no private insurance, out-of-pocket costs vary widely. In some parts of the country, out-of-pocket costs for people living with type 1 diabetes can be higher than $18,000 per year out-of-pocket; for type 2 diabetes, they can be higher than $10,000 per year in out-of-pocket expenses. Even those with private insurance can face high co-pays or exceed annual plan maximums, resulting in high out-of-pocket costs. Even for cases in which an individual is not accessing devices that cost thousands of dollars, they can face significant out-of-pocket costs. For example, we can consider a woman in her mid-twenties who is working a minimum wage job. An IUD, one of the most effective forms of birth control, can cost up to $500 with no insurance. Even with private insurance, a co-pay of 20% would be $100. While IUDs can last from three to 12 years and save money over the long term, the high upfront cost can make them inaccessible. Under-insurance can be a particular concern for young adults, who age out of their parents' private insurance but do not have their own form of private coverage. Lower-income Canadians also make up a disproportionate share of the under-insured. While most provinces have put drug coverage in place for those accessing social assistance benefits, a gap clearly persists. Many lower-income households that do not qualify for social assistance continue to struggle with out-of-pocket prescription drug costs. Employment factors contribute to differences in insurance coverage. People with low-paying jobs, such as entry-level, contract and part-time positions, often report less adequate drug insurance coverage. This may even discourage people who are accessing social assistance benefits from applying for jobs: Once hired, they may lose their public drug coverage, but many entry-level and part-time jobs do not offer drug benefits. One study found that only 27% of part-time employees reported receiving medical benefit coverage. Under-insurance can have serious consequences. Many Canadians with high out-of-pocket costs report forgoing essential needs, such as food and heat, or not adhering to their prescriptions because of the costs they have to pay. Statistics Canada also found that, in 2021, close to one in five Canadians spent $500 or more out-of-pocket for their prescription medication; almost one in 10 reported not adhering to their prescription medication because of costs. This includes delaying filling prescriptions or skipping doses in order to save money. When people do not take their prescription drugs the way they are supposed to, their health can suffer, and this results in serious consequences for the individual and their household. It also results in unnecessary costs to the health care system, as patients are more likely to visit an emergency room and be admitted to hospital. For example, the full cost of diabetes to the health care system in 2018 was estimated to be around $27 billion, and it could exceed $39 billion by 2028. I think we can all agree that no Canadian should be put in a position where they must choose between the prescription drugs they need for their health and well-being and putting food on the table. This is unacceptable, and it is why we are continuing our work to improve accessibility, affordability and appropriate use of prescription drugs as we move forward with national universal pharmacare. I am thankful for the opportunity to speak to a very important bill, as we start the debate and move towards to the legislation passing in this House.
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