The federal government must create a national catastrophic drug program to ensure that cancer patients don't have to worry about financial ruin while fighting for their health, says Roy Romanow, who headed a royal commission that called for such a plan years ago.
The strong warning follows a Globe and Mail story that showed how cancer patients in Atlantic Canada are taking out loans, racking up credit-card debt and rationing pills in an effort to afford crucial, costly prescriptions.
"We're talking about people losing their life savings or going without care," Mr. Romanow said. "It's outrageous.
"If we don't do it, I think, it just leads to a rallying cry for what I think would be a disaster for Canada, and that is the dismantling of the principles of the current structure."
The Globe report looked at the case of one Newfoundland cancer patient -- Rhonda Morey, a young mother of two -- who rationed her anti-nausea drugs because at $30 a pill, they were too costly. She still owes $4,000 of the $10,000 she spent on cancer treatment, including prescriptions, on her credit card.
"It's a crying shame that there hasn't been more exhibited political will here to act when, regardless of who the authors are, the evidence seems to be abundantly clear that it's affordable and it's the right thing to do," Mr. Romanow said.
An estimated 3.5 million Canadians have inadequate public or private insurance protection against the risk of catastrophic drug expenses.
But nowhere is the situation worse than in Atlantic Canada, where 600,000 people -- about 24 per cent of the population -- have no coverage. That is because cancer patients on the East Coast are victims of geography, living in provinces where the social safety net does not include significant pharmacare coverage.
As head of the Commission on the Future of Health Care in Canada, Mr. Romanow proposed in 2002 that the federal government reimburse 50 per cent of public drug-benefit plans above an annual personal threshold of $1,500.
That same year, Senator Michael Kirby also proposed in his Senate committee report on health care a plan to deal with catastrophic drug costs that would see individual spending on drugs capped at 2 per cent of income. The cost at the time was calculated at $600-million a year.
Yesterday, Mr. Romanow said a catastrophic drug program, which he described as economical, affordable and doable, could be developed in a few months and implemented soon after that.
He was one of many calling for prompt federal action on a catastrophic drug program, something that has been exhaustively studied and recommended.
In fact, the call for a national pharmacare program can be traced back 42 years to a Royal Commission on Health Services report. A national pharmacare program was also recommended by the National Forum on Health in 1997 and in the Liberal Red Book that same year.
Tom Osborne, Minister of Health and Community Services for Newfoundland and Labrador, said such a program would cost only $2-billion annually to fund across Canada.
"The federal government has to come onside here. Forty-six cents out of every dollar budgeted in this province is spent on health," Mr. Osborne said. "We are doing what we can afford to do. We recognize people need accessible and affordable drugs and we're prepared to do more if the federal government is prepared to partner, join with the provinces in providing a catastrophic drug program."
What Newfoundland and Labrador can afford is the expansion of its drug program to an additional 100,000 low-income residents this January. However, co-payments are required.
"What we're asking the federal government is very affordable, very achievable," Mr. Osborne said. "It would give all Canadians equal access to affordable drugs."
However, Mr. Osborne said he is not encouraged by what he has heard so far. When he met federal Health Minister Tony Clement in September, he said, there was no interest in a catastrophic drug plan.
"His comments were that he had neither the money nor the mandate to negotiate catastrophic drug coverage," Mr. Osborne said. "It was disheartening."
Yesterday, at a waiting-times conference in Toronto, Mr. Clement described work on a catastrophic drug plan as "ongoing" and said he expected it to be a topic of conversation at a meeting of federal, provincial and territorial health ministers next month in Moncton.
