Canadians may experience more limited access to new drugs and poorer health-care outcomes.
Every province offers drug coverage to social assistance recipients at low or no cost.
In Alberta, just about everyone under 65 can enroll in the province’s plan.
Worried about rising expenditures for prescription drugs, many states are employing preferred lists to encourage doctors to prescribe older, lower-priced drugs and forego the latest, more expensive medicines.
If Congress succeeds in passing a Medicare prescription drug benefit this year, the debate over preferred drug lists - now raging in numerous states - is likely to explode onto the national stage.
The lists - also known as formularies - are, whether we like it or not, a form of rationing. Ask any Canadian.
The existence of independent provincial Pharmacare programs and private insurance for prescription drugs is considered by some to be a blot on Canadian medicare. They want these options abolished in favour of National Pharmacare.
Health care costs are rising, and prescription drugs are taking up a larger share of those costs, but the change is a lot less dramatic than people think. Prescription drug costs were 8 percent of total health costs in 1991, and 12 percent in 2001, an average increase of less than half a percentage point a year.