Author Topic: Ontario: Single Payer Prescription Drugs for Children  (Read 4044 times)

FrugalToque

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Ontario: Single Payer Prescription Drugs for Children
« on: May 02, 2017, 06:24:13 AM »
Basic prescription drugs (including birth control, obviously) will be covered for anyone 24 and under.

The program starts in 2018.  Great news for the FI crowd with children, and there's always the possibility this spreads to the rest of the Canada.

http://globalnews.ca/news/3410017/ontario-budget-2017-families-get-free-prescriptions-drugs-for-children-more-aid-for-students/

FIRE Artist

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #1 on: May 02, 2017, 06:48:31 AM »
Pharmacare Canada wide will happen in my lifetime, of that I am convinced, I just hope it comes sooner rather than later.

Ottawa

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #2 on: May 02, 2017, 06:59:23 AM »
Yes, this certainly has positive implications as you suggest.  Although not overly likely (statistically) that anyone under 24 will require expensive drugs this is a very nice security blanket.  I, for one, who will be leaving the comfort of the public service health plan for around 15 years am definitely pleased.  This was one of the small voids in our FIRE plan that is now filled. 

mm1970

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #3 on: May 02, 2017, 09:03:38 AM »
I have college friends who have 2 children with type 1 diabetes.  This would be a boon for them.  Alas, we are in the US.

scottish

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #4 on: May 02, 2017, 05:07:25 PM »
I am confused by this.   Ontario also has the Trillium drug plan which is supposed to cover your drug expenses once they exceed 4% of your gross.   It's designed specifically for people who don't have drug benefits through work.

So... is Trillium not working?   do I misunderstand the plan?    Or is this about eliminating the 4% deductible?


daverobev

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #5 on: May 02, 2017, 07:05:35 PM »
Drives me crazy. Ageism/voter bribery is so rampant.

They need to... just reform all this. Make it free or nearly free at the point of use for everyone. Raise tax rates slightly to pay for it (get rid of the stupid Ontario health premium shit; just roll it in to the tax rates!).

Include dental. Include vision (again, with minimal contributions if you like).

Health isn't optional. Just like roads.

FrugalToque

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #6 on: May 03, 2017, 06:03:41 AM »
I am confused by this.   Ontario also has the Trillium drug plan which is supposed to cover your drug expenses once they exceed 4% of your gross.   It's designed specifically for people who don't have drug benefits through work.

So... is Trillium not working?   do I misunderstand the plan?    Or is this about eliminating the 4% deductible?

https://www.ontario.ca/page/get-help-high-prescription-drug-costs
It looks like the Trillium program is fairly complicated, requiring all sorts of information about the family's income, relationships and other factors.  Even then, the deductible is 3 to 4% of your income.  This new plan, which doesn't sound too thoroughly fleshed out yet, looks like it just covers your kids, period.

Fewer rules.

They need to... just reform all this. Make it free or nearly free at the point of use for everyone. Raise tax rates slightly to pay for it (get rid of the stupid Ontario health premium shit; just roll it in to the tax rates!).
...
Health isn't optional. Just like roads.
I'm with you on all that.  I can't stand the "surtax" or the "health care levy".  Just set the progressive tax brackets properly and be done with it.

Toque.

NorthernDreamer

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #7 on: May 03, 2017, 09:02:30 AM »
The Trillium drug plan does have exclusions. My husband is on Remicade (costs upwards of $25,000/year - yes, in Canada) and it is not covered by the Trillium drug plan. Before we had work health insurance that covers his prescription, we found all this out. Luckily the manufacturer offers its own income-based coverage for those without private insurance. I am hoping that a more affordable biosimilar drug comes out before we FIRE. Or that hopefully our on-paper income will be low enough that we can get some covered by the company. We are hoping to FIRE in 13 years so I have some time to figure all this out.

I do know someone whose 9-year-old is also on this drug. It would be wonderful if it would be covered for them under this new plan.


snacky

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #8 on: May 03, 2017, 09:44:25 AM »
I don't understand a universal health care system that excludes medicine, eyes, and teeth. I have never and will never comprehend a definition of healthcare that excludes body parts.

daverobev

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #9 on: May 03, 2017, 09:58:49 AM »
I don't understand a universal health care system that excludes medicine, eyes, and teeth. I have never and will never comprehend a definition of healthcare that excludes body parts.

Thank God it's not just me.

One of the stronger reasons for us moving back to the UK is simply that (not that the NHS is perfect, I know it's under attack/a lot of stress). But here it's just... oh, the political infighting between state (as in, federal) and province; the smug politics... ugh.

I mean, in theory, Liberal is where I should fit, mostly. Or some Liberal/Conservative cross.

I guess I just need to stand for election. Problem is, I'm a massive introvert. Knocking on doors is anathema. But I really feel... people need to stand up and shout. It's crazy how overcomplicated stuff is made, for no good reason.

scottish

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #10 on: May 03, 2017, 03:06:29 PM »
The Trillium drug plan does have exclusions. My husband is on Remicade (costs upwards of $25,000/year - yes, in Canada) and it is not covered by the Trillium drug plan. Before we had work health insurance that covers his prescription, we found all this out. Luckily the manufacturer offers its own income-based coverage for those without private insurance. I am hoping that a more affordable biosimilar drug comes out before we FIRE. Or that hopefully our on-paper income will be low enough that we can get some covered by the company. We are hoping to FIRE in 13 years so I have some time to figure all this out.

I do know someone whose 9-year-old is also on this drug. It would be wonderful if it would be covered for them under this new plan.

I have a similar need for these expensive meds.   I've always had private insurance, but I have the impression Trillium will sometimes cover them through the 'exceptional access program'.   Is there something special about your husband's case that he was denied coverage?   I think there is a biosimilar for Remicade out now, can't remember the name.

My solution is to accumulate an extra 500K before retirement so that I won't get stuck.   Most people can't/won't be able to do that though.

NorthernDreamer

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #11 on: May 05, 2017, 08:50:18 PM »
The Trillium drug plan does have exclusions. My husband is on Remicade (costs upwards of $25,000/year - yes, in Canada) and it is not covered by the Trillium drug plan. Before we had work health insurance that covers his prescription, we found all this out. Luckily the manufacturer offers its own income-based coverage for those without private insurance. I am hoping that a more affordable biosimilar drug comes out before we FIRE. Or that hopefully our on-paper income will be low enough that we can get some covered by the company. We are hoping to FIRE in 13 years so I have some time to figure all this out.

I do know someone whose 9-year-old is also on this drug. It would be wonderful if it would be covered for them under this new plan.

I have a similar need for these expensive meds.   I've always had private insurance, but I have the impression Trillium will sometimes cover them through the 'exceptional access program'.   Is there something special about your husband's case that he was denied coverage?   I think there is a biosimilar for Remicade out now, can't remember the name.

My solution is to accumulate an extra 500K before retirement so that I won't get stuck.   Most people can't/won't be able to do that though.

It might be different now. He started on the drug in 2010. It is a miracle drug, that's for sure. His doctor calls it a "circling the drain" drug. Luckily it's fully covered by both our workplace health plans. I read about the Americans worrying about healthcare in retirement with what's happening with the ACA, and I'm glad we are not in a similar situation. But if he will still be on this drug when we FIRE we need to take paying for it into consideration.

pumpkinlantern

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #12 on: May 05, 2017, 09:35:17 PM »
The Ontario government is trying to buy votes.

They are creating "niche" programs to fund relatively inexpensive projects that will only affect a very small portion of the population (drugs for healthy young adults, IVF for same-sex couples, etc.) in order to win votes, but are not funding expensive, core things that are required by a lot of people (eg. hospital beds, nursing homes, doctors, nursing staff, physiotherapy, drugs, etc.).  Its just to buy votes.

Multiple hospitals are routinely spending months at over 100% bed space capacity.  They close down hospital beds and force ORs to "go on holiday" over the summer months in order save money (obviously increasing surgery wait times).  They shut down CT or MRI scanners on evenings/weekends/nights (except for emergencies of course) even though they could easily scan people on waitlists in order to save money.  They are understaffing nurses and cutting physician budgets.  There's a bloating bureaucracy with layers and layers of bureaucrats telling front-line staff what they can't do.  It's gotten much worse over the last 5-10 years - I'm a physician in Ontario and I see it happening and anyone in health care can tell you the same thing.

One person on this forum mentioned not being funded for remicade.  This is a routine thing.  They won't pay for some very expensive biologics (or cancer drugs, etc.) even when there's good evidence that they are good - it's completely a financial thing.  Physicians (especially oncologists, rheumatologists, etc.) spend hours writing letters or calling drug companies and government agencies begging for their patients to get limited use codes for these drugs. 

There was that sad and well-publicized case of the teenager who died waiting for a stem cell transplant.  She actually had a donor and we have the expertise to do it - they just needed the funding from the government to do the case.  Physicians had been writing the government bureaucrats for years telling them about the funding problem (like so many other underfunded problems).  Of course they did absolutely nothing until this poor girl died and it made the news.  http://globalnews.ca/news/2678113/ontario-teen-who-died-waiting-for-stem-cell-transplant-begged-government-to-cut-wait-list/

Anyways, I'll stop my ranting...  My initial point was to say that for FI people, it is actually worthwhile to consider potential health care costs despite our "universal health care".  Even with our "universal health care", if you get a chronic disease (diabetes, heart disease, and even some cancers now), you will quite likely have to pay for some costs such as medications, support devices, hired help, physiotherapy, etc.  You may also need to pay for costs of ageing (nursing home or additional help at home).
« Last Edit: May 05, 2017, 09:36:53 PM by pumpkinlantern »

thriftyc

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #13 on: June 11, 2017, 04:34:46 PM »
Agreed - I don't think I will be employed in 2018, and I have 3 kids.  At least not employed in the traditional sense.  :-)

daverobev

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Re: Ontario: Single Payer Prescription Drugs for Children
« Reply #14 on: June 11, 2017, 06:17:33 PM »
God, I swear, if I wasn't an angry ranty introvert I'd start a political party.

A... "we will do our best to *serve*, and not just our constituents, and not just for the next 4/5 years, for the greater good of the planet".

I'd never get voted in.

Someone suggest a good job for an angry ranty introvert that could actually help with all this stuff? I'm... actually in need of a career or cause or something.