Ensuring Canadians can afford needed medication

Prescription medication is a critical part of a high-quality, patient-centred and cost effective health care system. Canada stands out as being the only country with universal health care that does not have universal pharmaceutical coverage; as a result, all too many Canadians are doing without critical prescription medication due to cost.

Research (pdf file) done by the Angus Reid Institute found that over one in five Canadians (23%) reported that they or someone in their household did not take medication as prescribed because of the cost during the past 12 months.

A significant and increasing number of Canadians are feeling the pressure of prescription drug costs, are unable to afford the medications being prescribed to them, and are compensating by skipping doses, splitting pills, or not filling their prescriptions.

These are among the main findings of a comprehensive public opinion survey conducted in 2015 by the Angus Reid Institute – in partnership with the Mindset Social Innovation Foundation and with the co-operation of renowned health policy researchers in Canada. This national study also finds a large majority of Canadians share the view that "medicine should be part of Medicare", supporting a national Pharmacare system that would cover the cost of prescription drugs.

There is decidedly less consensus on what the program should look like and – especially – how it should be funded. This complete report including detailed tables and methodology can be found at here

Key Findings

•      More than one-in-five (23%) report that in the past 12 months they or someone in their household did not take their medicines as prescribed, if at all, because of the cost

•      Regionally, BC and Atlantic Canada show the highest levels of access problems (29% and 26% respectively)

•      Cost barriers affect Canadians of all ages

Many Canadians cannot afford their prescribed meds Nearly one-quarter (23%) of Canadians report that, in the past 12 months, they or someone in their household did not take their medicines as prescribed, if at all, because of cost. Statistics Canada's Survey of Household Spending reveals that spending on medication by households headed by a senior is the highest among all age groups. Despite provincial/territorial coverage, 12% of senior’s report skipping medication due to cost. Specifically:

•      About one-in-seven (14%) reported that they or someone in their household did not fill a prescription at all

•      One-in-ten (10%) did not renew a prescription

•      And one-in-seven (15%) did things to make a prescription last longer (such as skip doses/split pills/etc.) due to cost. Survey results highlight access barriers in all provinces, with variations that may reflect public coverage policy. For example:

•      B.C. has the highest rate of access barriers: 29 per cent don’t take medicines as prescribed, if at all, possibly because government in B.C. offers only “catastrophic” drug coverage

•      Atlantic Canada is also relatively high (26%).This too may be because of the limited nature of provincial drug plans in the region Cost barriers affect ages and income levels differently

•      All age groups experience some difficulty filling prescription drugs:

•      Almost three in ten (28%) adults under age 45 do so. This level was reported even by the youngest group, aged 18 to 24 (27%). This group generally also has lower income and less drug coverage.

•      Though older Canadians are less likely to experience access barriers to prescribed medicines, they still report experiencing such barriers at relatively high rates compared to other comparable healthcare systems around the world (2014 Commonwealth Fund International Health Survey pdf file). 

Have you found love yet?

When you begin to find love, in people and places where you haven't found it before, it's always because you've grown. It is also because you are open to new experiences, thoughts and dreams. Growing is good for the soul no matter what age! 

Will you be healthy in retirement?

Don't put off your retirement... you'll may end up sick!  A study  on Healthy Life Expectancy (pdf file) shows that living longer does not guarantee people will be fit enough to work into old age

Life expectancy increased by 10.1 years worldwide from 1990 to 2015. However, healthy life expectancy – the time people will live without illness or disability seriously affecting them – grew by an average of only 6.1 years. If you are a high income individual your life expectancy is higher than those who have middle, or lower income globally. 

Worldwide if you are 65 today and are in a low income, you can expect to live:

• If you are a women another 13 years with 4 of those years in poor health. 
• If you are a man another 12 years with  3 of those years in poor health.

If you have a high income you could expect:

• If you are a women another 21 years with only 5 of those years in poor health. 
• If you are a man you with a high income you could expect to live another 18 years with 4 of those years in poor health.

In the chart below I show how long a person who is 65 and in a high income bracket, may live (in various countries) in good health and how long they can expect to live in poor health. This also has huge implications for health care in each country.

Country Age 65 Now	Women Life Expectancy		Men’s Life Expectancy
	In Good Health	In Poor Health	In Good Health	In Poor Health
Canada	Another 21 years (86)	For 5 of the 21 years	Another 18 years (83)	For 4 years of the 18 years
United States	Another 21 years (86)	For 6 of the 21 years	Another 18 years (83)	For 5 of the 18 years
UK	Another 20 years (85)	For 4 of the 20 years	Another 18 years (83)	For 4 of the 18 years
Russia	Another 17 years (82)	For 4 of the 17 years	Another 13 years (78)	For 5 of the 13 years
Germany	Another 21 years (86)	For 5 of the 21 years	Another 17 years (82)	For 4 of the 17 years
France	Another 23 years (88)	For 6 f the 23 years	Another 18 years (83)	For 4 of the 18 years
Ukraine	Another 19 years (85)	For 5 of the 19 years	Another 16 years (81)	For 3 of the 16 years
Australia	Another 22 years (87)	For 5 of the 22 years	Another 19 years (84)	For 5 of the 19 years

Happy?

Some studies conclude that older people have lower expectations so they are happier with less than they once were. Other results point to more realistic and mature attitudes that provide older people with wisdom and the importance of what contentment really is about.

People who enjoy life in general, age better, are healthier, fitter, and more active. Amherst College’s research in longevity has also credited friendship and social connection with:

• Boosting happiness
• Lowering risk of mental illness
• Improving self-worth
• Providing fun

A 10-year study of 1,500 people 70 and over conducted by the Australian Longitudinal Study of Aging (pdf file) reported that those with the strongest network of friends and confidants were 22% less likely to die during the study than those with the weakest network of good friendships.

Key Findings 
1. Participants have aged with differing degrees of success. Those classified at Baseline as ageing less successfully were more likely to die in the intervening eight years. 

2. Risk factors for mortality included 

• Undernutrition
•  Lack of exercise: people who did not exercise were found to be at high risk of mortality over the first 2 years of the study. Those who reported exercising more survived longer were more likely to be male and have better self-reported health 
• Social networks comprising discretionary relationships were protective against mortality in a ten year follow up. This was found for participants living in both the community and residential care facilities. 
• Psychological factors including intact cognitive functioning, a higher expectancy of control over life, and for women, better morale, were linked to better survival odds over 8 years, independent of health and physical functioning. 
• Depressive symptoms present a greater risk of mortality for men than women, with incident depression in old age representing a greater risk for men. 

Since there is absolutely nothing you can do about the number of years you have lived or will live, the only logical conclusion is to embrace whatever number you are currently at, and then forget it. 

Do everything possible to do what makes you feel good and discover how good you do feel when you help others. Other than that, if being happier means Botox, injectable wrinkle fillers or platelet-rich plasma therapy, go for it. If none of that is for you, trying taking a brisk walk every day. 

Eat healthier. Every positive step begets another. Put a few positive steps together and watch for the change in attitude = happiness that results.