OHIP+ : Who is it really helping?

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OHIP+, the Liberals’ appropriately named expansion of Ontario healthcare, came into effect on January 1st. The new program allows anyone under 25 in Ontario already covered by OHIP to access more than 4400 common prescription drugs for free. Parents and students couldn’t be happier, and the polls show high support for the initiative. Sounds great, right?

Not so fast. Kathleen Wynne, do you accept constructive criticism of your policies? Let’s consider the NDP’s less-discussed pharmacare program proposal. According to their website, the NDP had hoped to make only 125 essential medicines free — much less than the 4400 offered by the Liberals — but intended to make these drugs free for everyone in Ontario, regardless of age. Hoping to fully implement the program by 2020, the NDP considered this policy to be the start of universal pharmacare for all Canadians. Costing only $10 million more than the Liberals’ proposed budget of $465 million, some argue that the NDP offered better drug coverage. If the goal is to pave the way for universal pharmacare, the NDP wins gold for its inclusiveness.

Many wonder how great a benefit OHIP+ will really be, considering that a significant number of eligible Ontarians were already covered under their parents’ private, employer-provided insurance. Helen Stevenson, former Assistant Deputy Minister of Health and CEO of Ontario Public Drug Programs, admits that she preferred the NDP approach, arguing that the Liberals’ OHIP+ “[shifts] costs from employers to government unnecessarily”.

After surveying the drug claims of over one million Ontarians and examining the drug expenditures of those under 25 within this group, Stevenson calculated that the cost of OHIP+ will likely be close to $840 million — a marked increase from the $465 million the Liberals are currently boasting. While the private sector will happily roll back employee drug benefit programs, taxpayers are left questioning why the financial burden is being shifted to them. One might even cautiously wonder whether OHIP+ has more to do with cutting corporate expenditures in the wake of Ontario’s minimum wage increase than it does with helping cash-strapped Ontarians get the medical care they need...

Eric Benchimol, a specialist at the Children’s Hospital of Eastern Ontario, has also voiced his concerns about OHIP+ and the unintended harm it could bring to his patients. Prior to the introduction of OHIP+, many of the children treated by Benchimol had their prescriptions covered by the private sector. These drugs required regular adjustment in response to disorders such as Crohn’s disease and ulcerative colitis, which, if unsuccessful, could result in an invasive surgical procedure to remove part of the gastrointestinal tract. When dealing with private insurance, specialists were granted the flexibility to adjust drug dosages when urgently needed. Benchimol states that this isn’t allowed under Ontario’s new pharmacare plan. Under OHIP+, specialists need to undergo the process of applying for exceptional access, and Benchimol fears how this may affect patients going forward if access isn’t granted in time.

OHIP+ will hopefully go down in Ontario’s history as the rocky beginning to universal pharmacare, and we must remind ourselves that major policy changes, such as this, start slowly and are prone to future tweaking. In the future, we should focus less on party affiliation and the fleeting nature of partisan decision making, and instead focus on utilitarian approaches to healthcare in Canada. Let us consider OHIP+ — flaws and all — to be the budding seed of a truly universal pharmacare for all Ontarians.