CMAJ Readers' Forum

Of fads and editorials [response]

Online posting: Oct. 14, 1997
Published in print: November 15, 1997 (CMAJ 1997;157:1354)
Re: The times they are confusing: what lies ahead for the new health minister and physicians in Canada?, John Hoey and Kenneth M. Flegel, CMAJ 1997;157(1):39-41 [full text / résumé]

In response to: B. Frankford


Two colleagues have disagreed with the position we took against pharmacare in our July 1 editorial.

We agree with Dr. Joel Lexchin’s implication that a cost is a cost is a cost. From the broad viewpoint of society it makes little difference who pays for a prescription drug (or, for that matter, a nonprescription one). However, in the politics of the turn of the century, it makes a huge difference. It seems clear to us that Candians do not want to pay higher taxes. Thus, it is unlikely that Canadian politicians will toss new money toward drugs, and they will be reluctant to accept theoretical arguments of potential cost savings. Pharmacare is a big-ticket item and a big risk. Its promoters need to address this basic political reality.

To Dr. Frankford we are tempted to respond "fiddle-faddle." Canadians benefit from an excellent medicare system that is universal to the extent that everyone is covered for the same services. But it is not comprehensive and was never intended to be. Lots of medical services are not covered by the public system, and we know of no other country with a publicly financed system of comprehensive health care coverage. Can our system be improved? Sure it can, but we are predicting that pharmacare will not be among the improvements.

One final point. The editorial section in CMAJ is a forum for the free expression of a clearly argued point of view on a matter of professional interest. The positions taken by the authors of editorials are not necessarily those of the CMA. Signed editorials are the responsibility of the author or authors, even when those authors are also editors of the journal.

John Hoey, MD
Editor-in-Chief
hoeyj@cma.ca
Ken Flegel, MD, MSc
Associate Editor
kflegel@RVHMED.lan.mcgill.ca


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