The Grass Is The Same Colour, Part II: Prescription Drug Woes On Both Sides Of The US-Canada Border
2020-02-13 from healthaffairs.org
Which industrialized nation with a fractured health care system and a divided government is having a high-stakes political debate over the cost and coverage of prescription drugs? Many Americans—and congressional observers—might be surprised that the United States is not alone in debating the cost of prescription drugs and policies to make them more accessible. Indeed, Canada—a country often held up by liberals in the US as an aspirational model for our health care system and seen as part of a potential remedy for our own drug pricing woes—is having a similar debate. As discussed in my prior blog posts based on a fellowship experience in Australia and a summit of health care stakeholders in the US and Canada, we can learn from other countries’ health care policies despite structural differences.
As a former Senate staffer who started during the bitter passage of the Medicare Part D program and left after the bitter passage of the Affordable Care Act (ACA), I was surprised to learn that an estimated one in five Canadians does not have access to prescription drugs. Much of my Senate career had focused on drug pricing policy, with importation often included among potential solutions; for instance, one of my first major accomplishments was helping the Senator I was working for pass a drug-importation budget amendment, which was the only Democratic amendment to pass in the 2004 budget markup. So needless to say, learning about some of the similar challenges facing our northern neighbor took up a lot of my time when I arrived at the University of Ottawa Centre on Governance as a Fulbright Scholar.
Just as US Medicare and Medicaid initially did not include outpatient prescription drug coverage, such coverage is excluded from Canadian Medicare, which was designed at a time when prescription drugs generally were not part of the standard of care. Enacting pharmacare, or universal prescription drug coverage, in Canada has gained more urgency recently. Parliament has several proposals, including one in a report from a government advisory council and one from the House of Commons Health Committee, to choose from.
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