Pharmacare in Canada: issues and opinions

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Reviews the weaknesses of private insurance as a response to escalating drug costs, and outlines the case for extending the universal publicly funded health insurance (as defined by the Canada Health Act) to cover prescription drugs. Discusses various options for containing the cost to the public sector, including patient cost sharing, formularies and generic substitution rules, and argues that there is a stronger case in favour of demand-side cost sharing for drugs than for physician services and hospital care. Describes existing provincial/territorial pharmamcare plans and compares them with the pharmacare system proposed by the National Forum on Health (NFH). Suggests that some degree of patient cost sharing would be desirable in the case of drugs, and also that a system with provisions for opting out (allowing citizens to substitute private insurance for the public plan) should be given serious consideration.