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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