Wednesday, December 14, 2016

It is not lack of access to pharmaceuticals that causes expensive complications, it is excessive access

Dear Alberta Views Editors;


I was shocked to read, in the November 2016 article by Linda Mcquaig, “Medicare On Trial”, that she viewed the inability to afford drugs as a major cause of “expensive complications” and ER visits. I support pharmacare because this situation may sometimes occur, but McQuaig did not provide evidence to persuade me that this is a major problem. What is a major cause of adverse events and ER visits is excessive access to drugs. A 1998 paper in the Journal of the American Medical Assocation, for example, estimated that 106,000 Americans are killed by properly prescribed drugs in hospitals. That would amount to about 10,000 Canadians every year. And this study did not consider drugs prescribed in other settings (nursing homes, prisons etc), over the counter drugs, and improperly prescribed drugs. Pharmaceuticals are, in fact, one of the leading causes of injury of death. Not lack of access to pharmaceuticals, but access that is too easy, in a culture that believes everything can be cured with a pill, with the finger of blame pointing at both on doctors and ordinary Canadians.

Everyone is now familiar with the epidemic of opiod abuse which was not started by illegal drugs dealers, but by legal drug dealers, an epidemic that is causing a trail of death and destruction all throughout North America. This epidemic will not be mitigated by pharmacare.

Pharmacare, and medicare in general, are only funding mechanisms, and can make access to medical treatment more equitable, but they can’t deal with the epidemic of over-treatment (which involves more than just drugs). I would challenge anyone to show that, in Canada, lack of medical treatment is anywhere near as big a problem as over-treatment, mostly the overuse of pharmaceuticals.  Solutions must involve the education of everyone, not just medical professionals, about the dangers of the medical system, beginning a process of eliminating the many unnecessary and unproven treatments.  One of the problems with fee for service, which it was good to see another article in Alberta Views questioning, is that it provides an incentive to treat, and a disincentive to not treat, even if non-medical alternatives, such as changes in diet, exercise and other habits, would be far safer and, in the long run, more effective. Increasing the health of Canadians would also requires governments to have the courage to stand up to big corporations that sell products that cause disease, such as the chemical and food industries. As an added bonus, less reliance on the medical treatment system for conditions like diabetes, would massively reduce the cost of the system.

Until this day comes, it is up to individuals to educate themselves and avoid the system, despite the fact that they’re paying for it, until they absolutely need it.

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