28 June 2019 13:30
Photo : Unsplash
The final report of the advisory Council on the implementation of the national health insurance drug talk for his presentation, on 12 June last. After the mixed reactions of theAssociation québécoise des pharmaciens propriétaires (AQPP), of Biosimilars in Canada or thecanadian Association of insurance companies of persons (CLHIA), it is the turn of Mercer to deliver its critical analysis.
In a white paper entitled ” prescription drug Insurance for all : still a missed opportunity ?, the consulting firm says that the project plan as presented in the final report is “unrealistic” and ” unsustainable “. It gives solutions to overcome the various problems it faces.
Threats for employers
“Some elements of the final report are beneficial, in particular the desire to develop a national strategy on rare diseases, but we believe that other elements are risks,” said Mercer.
The firm describes the project of a universal regime, public and single-payer d'” incredibly generous “and feared that the latter” is not sustainable in the long term.” Three elements in particular feed on the anxiety of Mercer, two of which are threats to employers and their employees :
- Inequalities in coverage of employees : a concern for employers
The minister of Health of Quebec, Danielle McCann, has already asked for a right of withdrawal of Quebec, with full compensation ” within the jurisdiction of the provinces.” The current draft leaves the option to the provinces to integrate the national insurance Scheme medicines. “It is a matter of concern. This would add yet another layer of complexity, inter-provincial, which may potentially inhibit the mobility of the workforce, ” says Mercer. According to the firm, employers may have trouble coming, or to retain employees in a province that does not provide the national Regime. “The complexity would be particularly acute for plan sponsors with members in several provinces — which is the case of many employers of the country, because the employees would now be covered by health insurance plans that differ from each other. “
- Too little time to rethink the salary compensation
The health-related benefits offered by employers to their employees represent a significant part of the total compensation, ” says Mercer. Because of this, the establishment of the national insurance scheme drugs would have ” important consequences not only on the management of the workforce, but also on the collective agreements concluded in the country.” For Mercer, an implementation of the Plan from 2022 “risk of creating chaos in the working relationship” because the employers have not had enough time to redefine the compensation that they offer to their employees.
- Franchises “really low” that does do not
The Plan provides that the Canadians will pay $ 2 for standard drugs and $ 5 for the most expensive, with an annual ceiling of $ 100 per person or household. This schedule is “too generous to be sustainable,” says Mercer. The firm recommends that the copaiement be supplemented by other measures of cost-share to “encourage Canadians to buy carefully” and avoid the mess. Mercer proposes the implementation of a deductible based on income or the application of a percentage of all applications for the regulation of drugs.
Mercer recommends that the advisory Council to make “significant changes” to his game plan. Otherwise, ” the national insurance Scheme medicines will fail, representing another missed opportunity to finally ensure health and drug coverage for all Canadians.”