Prescription Drug Coverage Outside of Hospital- A Method of Modernizing the Canada Health Act
The Canada Health Act was put in place 39 years ago by our federal government and focuses on the following funding principles: comprehensiveness, accessibility, universality, public administration and finally portability (Flood, C.M. & Thomas, B., 2016). This Act defines insured services as “medically necessary hospital, diagnostic, medical and surgical-dental services” (European Observatory of Health Systems and Policies et al., 2020). In my opinion, our health care system and medicare needs have changed drastically since 1984. It’s evident that our population is growing and aging, and it is important that our healthcare system can mold according to our needs. According to the European Observatory on Health Systems and Policies et al. (2020), the lack of coverage for prescription drugs outside of hospital is one of the main areas for improvement for Canadian medicare. This is most noticeable in my practice while discharging and beginning rehabilitation for patients with cardiac diseases. Our patients diagnosed with heart attacks, heart failure, diabetes and other cardiac conditions require strict adherence to medications to prevent readmissions and slow the progression of their conditions. Unfortunately, from my experience many of our patients are now diagnosed under the age of 65 and do not qualify for provincial government assistance, and many do not have adequate drug coverage from their private work insurance. As a result, I see patients re-admitted with cardiac symptoms, stent restenosis, and heart failure exacerbations. Evidence shows that over 5,000 deaths and 2, 700 heart attacks were considered avoidable if better medication coverage was available to patients diagnosed with diabetes under the age of 65 (Booth, et al., 2012). Thus, a more preventative approach to medication adherence by considering prescription drug coverage “medically necessary” is important as our healthcare needs evolve.
References
Booth, G. L., Bishara, P., Lipscombe, L.L., Shah, B.R., Feig, D.S., Bhattacharya, O., Bierman,
A.S. (2012). Universal drug coverage and socioeconomic disparities in major diabetes
outcomes. Diabetes Care, 35(11), 2257-2264. https://doi.org/10.2337/dc12-0364
European Observatory on Health Systems and Policies, Marchildon, G.P., Allin, S., Merkur, S.
(2020). Canada: Health system review. Health Systems in Transition, 22(3), 0-228.
Flood, C.M. & Thomas, B. (2016). Modernizing the Canada health act. Ottawa Faculty of Law
Working Paper No. 2017-08, 401. https://papers.ssrn.com/abstract=2907029
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