Winners and losers in the plan to equalize access to medication

Ottawa is one step closer to implementing a national prescription drug program that aims to give all Canadians equal access, but has some patients wondering why their costs for devices and treatments are not part of the plan.

Patients out thousands for medical devices seek national plan where all Canadians get same coverage

Rowan Burdge estimates treating her Type 1 diabetes has cost her about $60,000 since she was first diagnosed. (Richard Grundy/CBC)

It's a big country, but Rowan Burdge who has Type 1 diabetes knows her medical condition means she can only afford to live in a few select provinces.

The woman who now lives in B.C. says she had to leave Nova Scotia and Saskatchewan after discovering big differences in what provincial health plans cover. Canadians have to live in a province for more than three months before they are covered by medicare there.

Over the years, she says she's had to spend more than $60,000 to cover the cost of insulin, testing strips and the insulin pump she needs for her condition.

"We're expected to fork over thousands of our own dollars just to be able to be alive," Burdge tells Go Public.

Burdge's insulin pump and related supplies are the biggest expenses related to her diabetes. If she lived in Ontario, those costs would be covered regardless of her income. (Richard Grundy/CBC)

"If I was unable to afford it, I would die. It's life-sustaining therapy, I don't have an option in taking insulin.

Sick Canadians across the country are contacting Go Public, frustrated with the country's so-called universal health-care system.

Many are struggling to afford the same medical treatment that is covered for people who live in other provinces.

They are hoping Ottawa's proposed prescription drug program will level the playing field.

Burdge, who lives in Vancouver, says B.C.'s  pharmacare program has some of the best coverage in the country.

The coverage is better, but the cost of living is higher, so Burdge has two private health-care plans in addition to her provincial coverage.

She still pays about $400 a month out of pocket. "It's hard enough to live with a chronic illness and a chronic health condition. I think it kind of adds insult to injury," she said.

National drug program

She is one of many hoping a proposed national prescription drug program goes ahead. The program would give all patients the same access to medication no matter what province they live in.

A report requested by the House of Commons standing committee on health found a national pharmacare program would save Canadians $4.2 billion a year by giving Canada bulk buying power for medications and reduce administrative and other costs related to the dozens of provincial health-care plans.

That report is now in the hands of the federal government, but Health Minister Ginette Petitpas Taylor was noncommittal when Go Public asked if the government plans to implement the program.

When questioned by Go Public about the proposal for a national drug plan, federal Health Minister Ginette Petitpas Taylor was non-committal. (Gabrielle Fahmy/CBC)

"Well, the first step forward right now is we're going to be putting in place the advisory council because we want them to look at all options that are available," she said.

Decades of failed attempts

Steve Morgan, a Canadian health economist and a professor at the School of Population and Public Health at the University of British Columbia, is optimistic the federal government will finally make prescriptions more accessible after decades of failed attempts.

He testified before the committee that put the report on a national pharmacare program together.

Health economist Steve Morgan says Canada needs to do a better job co-ordinating health care resources. (Cliff Shim/CBC)

One of the problems, he says, is convincing pharmaceutical companies that stand to lose billions that a national system is the way to go.

"The reality is that we shouldn't be paying any price for any drug. We need to have a system that is rigorous, robust, and accountable to Canadians," he says.

Forgotten patients

The government is only considering equalizing access to drugs, not medical devices, which many would like to see.

Hearing-impaired Calgary man Peter Pawlik is one of them.

Pawlik and his parents fought to get the Alberta government to pay for a life-changing hearing implant — a bone-anchored device called Bonebridge — after realizing the same operation was covered in other provinces.

Even though half the provinces in Canada have decided the implants should be publicly funded, Alberta Health told Go Public that the last time it looked at insuring the surgery was in 2013 when it decided there was a lack of evidence that the implants were safe and effective.

Peter Pawlik has anxiety related to air travel, so he boarded a cargo ship in New York to go to Europe for a surgery to improve his hearing. (Courtesy Peter Pawlik)

The Pawliks also tried to get the surgery done in another province, offering to pay out of pocket, but were told Peter would have to wait a year or more.

They eventually opted to travel to Europe so Peter could get the hearing implant surgery there — at their expense.

Go Public first told the 36-year-old's story in December.

At the time, Pawlik, who suffers from mental health issues his psychiatrist links to his inability to hear, was on his way to Austria to get the surgically implanted medical device that would allow him to hear clearly for the first time.

WATCH: Peter Pawlik's first time hearing clearly 0:14

Pawlik is now back in Canada and the hearing device has drastically improved his life, according to his parents.

The surgery and related hospital costs left the retired couple more than $60,000 in debt.

Peter Pawlik's parents, George and Yolanta Pawlik, now have more than $60,000 of debt after paying privately for their son's operation and related costs. (Dave Rae/CBC)

"I absolutely think it is not fair. Not only for his [Peter's] condition, for different conditions." said Jolanta Pawlik, Peter's mom.

"It's just one country and it's just ridiculous that one province is saying, 'well I'm paying,' and then you are living in a different province, they are not paying. It's just strange."

With files from Jenn Blair and Gabrielle Fahmy

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About the Author

Rosa Marchitelli is a national award winner for her investigative work. As co-host of the CBC News segment Go Public, she has a reputation for asking tough questions and holding companies and individuals to account. Rosa's work is seen across CBC News platforms.


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