Is the Campbell government really trying to create a market for private health insurers? Health Planning Minister Sindi Hawkins provides a disturbing suggestion of that possibility in her ministry's "Service Plan". One of the performance measures she has chosen for determining whether BC has a sustainable, affordable health care system involves insurance coverage for prescription drug costs.

Before the Campbell Liberals started to dismantle Pharmacare, no one would have thought to ask whether anyone was not "appropriately insured for prescription drug costs". "Appropriately insured" is the kind of double speak that is found throughout the New Era Document. Whether you have private health insurance or not, everyone in BC at least has the benefits of universal Pharmacare and better benefits if you are over age 65 or in some other specified group based on need or disease. After the last increases in user payments, universal Pharmacare coverage provides:

That means private insurance currently only insures prescription drug costs to a maximum of $2,000 per year per family. But the Campbell government is talking about eliminating universal Pharmacare as well as Pharmacare for some seniors based on an income test. The service plan for Health Services shows an expected cut of almost $90 million to Pharmacare between fiscal 2002-03 and fiscal 2003-04, and that is in absolute terms meaning that 14% per year inflation in drug costs is on top of that!

Eliminating all Pharmacare coverage for some people means that instead of having a risk of a maximum of $2,000 per family per year, some families could have virtually unlimited risks. In practical terms that means a risk of $20,000 or more for some serious illnesses that require very expensive medications. On top of that, private insurers will not pick up that "major medical" risk for anyone with a pre-existing condition.

Spaceship to planet Hawkins: Private sector insurers, including the non-profit Blue Cross, do not offer individual coverage for pre-existing conditions. When you cut people off, private insurers will not pick up the "bad risks". So where does government get off saying that one of its performance measures is 100% coverage for prescription drugs costs?

The no pre-existing condition clause does not usually apply to group insurance contracts. For those who have health benefits (usually called Extended Health Plans) through their employer, the plan may pick up the cuts or the plan may be changed to pass on the costs through reduced coverage or higher deductibles. For those who lose their job, are retired or otherwise do not participate in a group plan, they are out of luck for any pre-existing conditions. That is exactly the kind of dilemma faced by millions of people in the US as they struggle to keep health insurance. For prescription drug coverage, it looks like BC will soon move closer to a US type system.

Changes to Pharmacare in 2003 will see people with serous illnesses denied eligibility while private health insurers refuse to pick up people who are certain loses!