Pharma burden must be shared

Of all the complaints that you can lob at the provincial government, one thing you cannot say is that they don’t listen to seniors. The conversation on the plan covering drug costs has been long and detailed.

Of all the complaints that you can lob at the provincial government, one thing you cannot say is that they don’t listen to seniors. The conversation on the plan covering drug costs has been long and detailed. A variety of advocacy groups have weighed in for a long time on Ron Leipert’s now-departed reform package on pharmaceuticals for seniors.

The longer the talks went, the more obvious it became that not everyone could be pleased.

There will be winners and losers. New Health Minister Gene Zwozdesky merely had to pick the largest group and attempt to help them win.

That group turned out to be middle- and high-income seniors, and older people fortunate or diligent enough not to require the average dosage of drugs given to people over 65.

These are the people who will be pleased that Zwozdesky made what is now his fifth reversal of health-care policy when he said last week that the reforms are on hold until they can be completely studied. Which basically means forever, or until somebody comes up with a new plan or it collapses entirely.

Low-income seniors, who would have become exempt from premiums and co-payments on drugs, would have saved an average of about $1,000 a year under the reforms. They’re not happy. And neither will be middle-income Albertans who aren’t yet 65; they will continue to shoulder the reported $20 million a year in costs that the reforms were supposed to save.

So right now, all seniors will pay 30 per cent of the cost of their prescriptions, to a maximum of $25 for each one.

That may not sound like much to the average working Albertan. But did you know the average Albertan over 65 uses six prescriptions a month? So says our health minister. So the average senior — regardless of income — pays $150 a month for drugs.

The reforms would have pushed costs up the ladder, so that a couple with a combined taxable income of $50,000 would each have paid $708 a year in premiums, and if they took the average six-a-month prescriptions the $15 co-payment would cost each another $1,080 a year.

We’ve been told for a long time that drug costs are the fastest-growing portion of the fast-growing costs of health care.

We’ve also been warned that sooner or later, the system must either change or fail.

In an essay in the Globe and Mail on March 29, entitled Saying no to the sick, historian Michael Bliss proposed that trying to maintain a top-flight health-care system that is free for all is like trying to keep a snowman from melting in spring. The higher the costs (or the temperature), the more difficult that becomes, until you fail.

As a society, we are aging. As individuals, we incur the highest health costs in the last few years of life, no matter if we live spryly to 85 or die of complications from a heart attack at 55.

We can no longer entirely pay up-front for health care via taxes through our younger working lives, to be carried by taxpayers when we get old — there won’t be enough younger people to shoulder the burden.

And, as Zwozdesky observed, the seniors demographic is getting wealthier as it gets larger. The baby boomers are the richest generation in human history.

The trick is in fairness, in being reasonable and pragmatic. Poor people may require a means test to gain cost exemptions. Richer people will need to accept that the cost of a comfortable citizenship includes subsidies for other people. Taxes generally will have to rise, unless we’re willing to say no to the sick.

Zwozdesky tried to do the best he could for the largest group, albeit for political reasons. Soon, he’ll just have to do the best he can, period, and just suffer the political consequences.

Greg Neiman is an Advocate editor.