Providing prescription drug coverage

First, I should apologize. This is not a thoroughly thought-out scheme but I’m having one of those nights where my mind races and I need to produce something from all that idle thought.

Let’s say, for the sake of argument, that we want the government to pay for:

  1. All catastrophic drug costs (for example, beyond a certain percentage of income)
  2. Most costs for low-income families and individuals
  3. The costs of certain drug treatments with strong societal benefits (like HIV drugs)

Right now there is a complicated patchwork of programs in Ontario which aim to accomplish those goals, but navigating the bureaucracy can be a daunting task for a sick person who needs financial aid. When dealing with multiple programs, it is also possible there are holes in the safety net.

I propose we transform the OHIP cards into a sort of pharmaceutical credit card. A patient swipes her card at the pharmacy, the pharmacist transmits the OHIP ID and prescription cost to the Ministry of Health where a computer quickly calculates the subsidy, and that information is sent back to the pharmacy. Then the patient decides if she wants to fill the prescription, knowing the ultimate cost. If yes, the province pays the pharmacist up front and collects what it is owed by the patient later.

This way, we can reduce the paperwork and delay, get the drugs to the people who need them, and tie up the loose ends later. All that is accomplished with relatively little information: income, drug expenditures, and drug identity. The most difficult part would be rearranging the machinery of government, not operating the program.


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