Let’s finish the job and implement Pharmacare

Medicare is a good idea but incomplete without Pharmacare. Let’s finish what we started in the 1960s. The plan was always to finish our health care system but realization of that dream got lost in perennial federal-provincial squabbling.

image: Green Party

Canada is an anomaly among nations. We are the only industrialized country with a universal public health care system but no Pharmacare.

Every study of Canada’s health care has identified the lack of Pharmacare as a major gap in our system.

Medicare without drug coverage doesn’t even make sense. What good is a health care system that prescribes drugs but doesn’t cover them?

What we now have is a mess. Drug coverage in Canada consists of a patchwork of 100 public and 100,000 private insurance plans. Some working Canadians are covered by employer-funded private plans. Seniors and those on social assistance are covered by publicly-funded provincial plans. Indigenous people, military members, federal inmates are covered by federal plans. Low-income Canadians struggle. In B.C. they have to pay up to the deductible amount.

Studies show that some low-income Canadians go without prescribed drugs because they have to buy groceries and heat their houses first. Women typically suffer more than men. Nearly two million Canadians reported not being able to afford one or more drugs in the past year. Unfilled prescriptions result in an additional burden on our health care system –patients end up going back to their doctor or to the hospital.

What we have is a mess and it’s ridiculous. When I go to the hospital, prescribed drugs are covered by Medicare and dispensed from the hospital pharmacy. When I walk out the door of the hospital, I’m on some other plan if I’m lucky, no other plan if I’m not.

The model of Medicare provides a good template for Pharmacare. While Medicare is universal in that it covers everyone, it is not universal in that it covers everything. This is especially true for Pharmacare as technology offers ever more expensive remedies. Pharmaceutical companies are coming up with new, expensive, drugs. Some are only marginally better, some no better than generic drugs. Pharmacare should not cover every conceivable pharmaceutical.

Drug spending in Canada has grown significantly over the past few decades, from $2.6 billion in 1985 to $33.8 billion in 2017, and the share of GDP spent on drugs has more than tripled from 0.5% to 1.6% over this period.

Pharmacare will reduce the amount we pay for drugs. Canadians pay among the highest prices and spend more on prescription drugs than citizens of almost every other country in the world. Among Organization for Economic Co-operation and Development (OECD) member countries, only the United States and Switzerland spend more per person each year on prescription drugs and pay higher patented drug prices than Canada.

The bickering between the federal government and the provinces over Pharmacare must stop. Now’s our chance. The federal government has opened a dialogue. What do you think? You can answer the questionnaire and make a submissions until September 28.

 

The first Canadians

We arrived in North America, in what is now Canada, 16,000 years ago. Within a few thousand years, three quarters of the continent’s large animals were gone.

   image: sciencemag.org

By “we,” I don’t mean we European colonizers, I mean we Homo sapiens.

There were no indigenous people when we arrived. Not like 70,000 years ago when we came to Europe from Africa. Then, the indigenous people of Europe were the Neanderthals. We probably treated them much in the way that Europeans treated the indigenous people of North America -as savages.

Am I equating indigenous people of North America to the indigenous people of Europe? Yes. We are all humans, says Yuval Noah Harari in his book Sapiens:

“Yet the real meaning of the word human is ‘an animal belonging to the genus Homo,’ and there used to be many other species of this genus besides Homo sapiens.”

We encountered other humans as we spread around the globe, probably with the same disdain. We dismiss other humans who look slightly different as inferior; it’s a convenient way of subjugating “others” and appropriating their land and resources.

The extent to which Neanderthals were human is indicated in our DNA. Shortly after arriving in Europe, the Neanderthals disappeared. There are two possible explanations: either sapiens and Neanderthals interbred to become one species or the Neanderthals died off, or we killed them. If we interbred, we are not “pure sapiens” but carry DNA of those other humans that we encountered –Denisovans from Siberia, Homo Erectus in East Asia.

DNA analysis reveals interbreeding. Europeans and those from the Middle East carry one to four per cent of Neanderthal genes. Melanesians and Australian Aboriginals carry six per cent of Denisovan genes. We humans are probably all one species, just as Spaniels and Chihuahuas are all dogs.

To the chagrin of racists, the only pure members of our species are found in Africa. The rest of us are just bastards.

When we walked into North America 16,000 years ago across the Bering Strait, we had no idea that we were walking into a new world. In just a few thousand years we traveled all the way to the island of Tierra del Fuego at the tip of South America. Along the way, we exterminated many species.

“According to current estimates, in that short interval, North America lost thirty-four out of forty-seven genera of large animals,” says Harari, “South America lost fifty out of sixty.”

After flourishing for 30 million years, sabre-toothed cats were gone as well as giant sloths that weighed up to eight tons. Gone were giant beavers, horses, camels and mammoths.

We arrived in Australia with the same disastrous results. Within a few thousand years, out of twenty-four species of large Australian animals, most of them marsupials, twenty-three became extinct.

The unsettling fact is that we were not good stewards of the land, not as first people and certainly not as European colonizers.

We sapiens are remarkable humans in other respects. We inhabit every corner of the earth. But I can’t help but feel that it’s going to end badly.

Maybe a new version of humans will rise, breed with us, and do a better job at living in harmony with the planet.

Burn all books about Sir John A.

The Elementary Teachers’ Federation of Ontario doesn’t go far enough when they recommend the removal of former Prime Minister John A. Macdonald’s name from schools because of his role in the “genocide against Indigenous people.”

Image: Maryland Faerie Festival Blog

Macdonald established reserves in order to clear Indigenous people from the land to make way for the railway. He rationed food on reserves that led to malnutrition, disease, and the deaths of thousands.

He should be erased. Statues and monuments should be torn down. His image on our ten dollar bill should be removed. All traces of his memory should be expunged. Why should we honour such a racist?

I searched the TNRD library and found 12 books with offensive titles such as “John A.: the man who made us: the life and times of John A. Macdonald How could a killer shape Canada? And “Sir John’s table: the culinary life and times of Canada’s first prime minister.” Who cares what he ate while starving children?

I “borrowed” a digital copy from the TNRD library of “The destiny of Canada: Macdonald, Laurier, and the election of 1891.” In it I learn that Macdonald appointed Indian agents in the West who used open ballots to track who voted for whom to ensure the re-election of Tories.

As a symbol of our collective disgust of the treatment of Canada’s Indigenous people, the books should be burned. What a cathartic feeling that would give to Canadians in relieving our guilt at the treatment of Canada’s first people! A good date for the book-burning would be Guy Fawkes Night on November 5 when we would gather in public squares while bonfires raged. How therapeutic it would be to dance in the light of the flames as our national shame when up in smoke!

Public burnings of ten dollar bills would further expunge our blame, similar to the Chinese tradition of burning “joss notes (unofficial banknotes).” Whereas the Chinese do so as offerings to the deceased, wealthy Canadians and corporations could set examples of our collective outrage by burning large quantities of ten-dollar bills. Such burnings would fortify their images as good citizens.

The hard drives of people who downloaded borrowed digital copies from libraries should be seized (except for mine, of course, which is for the purpose of research only.) The names of those library patrons (except mine) who have borrowed hard and digital copies of books should be reported to the Ministry of Pure Thought.

The complete purge should start with Macdonald and continue with other villains such as Hector-Louis Langevin and Egerton Ryerson, who promoted residential schools; Edward Cornwallis, who placed a bounty on Mi’kmaq scalps; Judge Mathew Begbie, who ordered the hanging of chiefs of Tsilhqot’in Nation for defending their land; and Paul de Chomedey, who killed an Iroquois chief with his bare hands.

The cleansing of Canada’s spirit should continue with the re-writing of history. More than just the political leaders of the past are to blame. The majority of Canadians who voted for them are at fault. We cannot let the evil views of Canadians from the past to warp our values today! Those views cast an ominous shadow over Canadians. History should reflect who we are now, not the warped morals of the past.