Thursday, September 11, 2014

The Explainer explains

Surveying corporate media coverage of the education dispute, I noted a column by Vaughn Palmer that displays his particular usefulness when BC Liberals want information distributed. More about education later but here is an excerpt from A balanced budget, but it’s not exactly ‘happy days’ in B.C. finance land:
"B.C. Liberals were forced to rein in spending by several hundred million dollars as well. Much of that was achieved by slowing the rate of growth in the health ministry, including some $100 million reaped in the Pharmacare budget from the continuing shift to generic drugs."
Obviously, what he should have said is not that Liberals were "forced to rein in spending" but that they "chose to rein in spending."

But, that's a minor complaint. When he wrote government saved $100 million by PharmaCare shifting to generic drugs, The Explainer had not spoken to users of prescription medications, he was reading from Liberal talking points. In fact, PharmaCare saved money but they gained most of it by shifting costs onto users. This has been accelerated recently.
  1. PharmaCare sets a maximum price it will recognize for each drug and patients pay the extra. Often, PharmaCare prices are lower than actual prices in the market place.
  2. PharmaCare has a Low Cost Alternative (LCA) program and will accept only amounts established for the cheapest drug in a category. If doctors prefers to prescribe drugs different than the LCA, the patients pay extra.
  3. Under the Reference Drug Program, PharmaCare provides full coverage for only the most "cost effective" drugs in the category. Coverage for other drugs may be will be denied without special authority.
  4. The Limited Coverage program dictates that certain medications will not be covered unless health care providers apply for special authority. The list of drugs not covered has expanded. Special authorities are often declined and physicians may ask patients to pay fees for applications. This encourages patients to abandon claims.
These policies not only save the BC Government large amounts but they profit private insurers, such as Pacific Blue Cross, who apply me-too rules and follow the PharmaCare model. So, government and business saved money, but that came out of the pockets of patients.

I can understand government not wanting to admit the fact but they should not be helped by misinformed reporters.






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9 comments:

  1. This has cost my family a bundle. And our pharmacist tells us a lot of seniors are walking away without their medications when they find out the new cost they have to pay.

    ReplyDelete
  2. I've had Pacific Blue Cross extended health for years. It is supposed to pay 80% of prescriptions but our family's additional out of pocket costs have been mounting recently. We pay almost twice what we used to because of the difference between Pharmacare's listed price and the pharmacy's charges. Numerous prescription drugs once covered are no longer eligible. For some prescribed drugs Blue Cross and Pharmacare pays nothing at all. For others, a special authority is needed. Our doctor doesn't like applying for those and refuses to get into arguments with Pharmacare if denied. His office won't do anything without charging a fee.

    A surgeon required that I use 3 different drugs before an operation. None were covered by Pharmacare. The surgeon said studies had shown fewer complications occurred with patients who used what he prescribed. Didn't matter to Pharmacare nor my insurer.

    You describe the situation accurately.

    ReplyDelete
    Replies
    1. All need to call their MP for a national prescription pricing program np3 for short so all Canadians pay same price coast to coast to coast

      Delete
  3. Here's a drug that can save my life. At the cost of $1000 a day.No coverage, no treatment until I either get cirrhosis or liver cancer. It's a weird world we live in.
    http://www.sovaldi.com/default.aspx

    ReplyDelete
  4. Does Mr Palmer have any liberal links like some reporters

    ReplyDelete
    Replies
    1. Vaughn Palmer is the biggest Liberal shill in BC ... and that's saying something. I would say he is a disgrace to his profession, continually prostituting himself for political ideology.

      Delete
    2. An absolute must read folks:

      http://www.straight.com/news/728166/deconstructing-bc-liberal-spin-campaign-protect-christy-clark-during-teachers-strike

      Delete
  5. Thank you for reporting the truth on this.

    Today, I picked up 4 prescriptions and had the pharmacy provide me low cost alternative prices for each of the drugs. What they charged me ranged from 105% to 115% of the LCA amounts published by Pharmacare on September 4.

    I have insurance but it recognizes only Pharmacare's LCA so, in addition to the usual co-pay, I have to pay the price overage. So, I visited three other pharmacies and asked what prices they charged. Each charged similar or higher prices that my regular drug store.

    There is nothing to stop Pharmacare for saving more money for themselves and insurance companies by widening the gap between prices consumers have to pay and the fantasy prices on the LCA list.

    Of course, it is not just government that is saving cash. It is the private for-profit insurance companies too.

    ReplyDelete
    Replies
    1. I checked a few prescription receipts we've collected in the past few months against the LCA list published by Pharmacare, which is here: Low Cost Alternative (LCA) and Reference Drug Program (RDP) Data Files Our drugs were the lowest cost generics in each case and they were bought from Superstore or Safeway pharmacies.

      The prices charged for the medicines (not including the dispensing fee) were 4% to 17% above the LCA. I can imagine it happening occasionally if prices are changing but each and every prescription required us to pay more than the supposed co-pay percentage. It's cost our family a fair few dollars but the total for Pharmacare would amount to many millions of dollars.

      Delete

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