David,
You may be aware of the Paharmaceutical Benefits Scheme (PBS) in Australia. This is a national programme that provides a wide range of prescription medicines at a government subsidised rate to all citizens. The government acts as bulk purchaser of the drugs and provides them, through pharmacies, at a capped price; $23.70 or $3.80 for people with social security pension cards. In addition, for people using large volumes of medicines, there are safety nets for expenditure. After spending $726.80 in a year a regular patient pays the consession rate for all subsequent medicines that year, while for concession card holders medicines are free after expenditure of $197.60 in a year.
The PBS has been in operation since the late 1940s and has widespread support from citizens. However, it is unpopular with pharmaceutical manufacturers since the government, as a bulk purchaser, is able to negotiate lower prices. Nonetheless manufacturers work ahrd to ahve their products lisetd for subsidy on the PBS as it ensures high volume sales; GPs prefer to prescribe subsidised drugs due to their lower cost to patients.
The whole process i now udner threat from the Free Trade Agreement that has been signed between Australia and the USA. This will threaten the independence of the Committee that chooses what drugs will be listed and may allow manufacturers to target the Committee in lawsuits over decisions.
Further information on the PBS can be found at
http://www.health.gov.au/pbs/
Sandy Leask
Health Improvement
Population Health Unit
PO Box 63, Penrith 2751
Wentworth Area Health Service
Ph: (02) 4734 1551
Fax: (02) 4734 3300
>>> David Zitner <[log in to unmask]> 05/26/04 02:02pm >>>
Chrystal, I understand your rant. In some areas those at low income have the highest marginal tax rate. Between incomes of $10,000 and $20,000 people sometime lose more than $1.00 in social entitlements as they increase their earned income.
For example, a couple with a chronically disabled child requiring expensive therapies might have to stay on welfare roles, because as they get above an earned income threshold they lose access to the expensive drugs their child needs. Many would prefer to contribute and be somewhat self sufficient, but in some circumstances it is impossible for people to earn the dollars necessary for appropriate drug coverage. Another reason, in my opinion, to have catastrophic drug coverage and to implement solutions to avoid penalizing and controlling people who try to develop creative and resourceful solutions.
Good Luck Chrystal, I hope that one of the political parties is able to develop and promote (and implement) a sensible solution to the problem you pose.
Good luck
David Z.
-----Original Message-----
> Date: Tue May 25 20:57:31 ADT 2004
> From: "Chrystal Ocean" <[log in to unmask]>
> Subject: Re: $3 billion for health care
> To: [log in to unmask]
>
> I agree with David Zitner. I'm a woman living below the poverty line whose
> health has deteriorated in tandem with my financial condition. Perhaps the
> 3 billion will ensure I get tended to when I need acute care? In the
> meantime, it feels like the misspent 3 billion is just one more nail in my
> coffin, and I and others like me will continue on the road to early death.
> Clearly, life for those living in poverty * never mind our quality of
> life - is a non-issue for politicians.
>
> I'm currently conducting a project that explores the links between
> policies of exclusion and poverty - without the appropriate means to get
> about in my largely rural community. I must walk everywhere: to network,
> to meet with media, to interview participants. It's not easy finding
> locations that are accessible to both participants and myself.
>
> The marginalized poor, in other words, are not only challenged to have
> energy left to advocate or seek solutions for themselves, they are kept
> physically without the means to do so. Of the women contacting me, most
> haven't a telephone. How are people expected to find work when they cannot
> easily be reached? More important, what happens in an emergency?
>
> The women joining this project are angrily and desperately trying to claw
> their way out of poverty. Yet added to the stress of not having adequate
> food, shelter, clothing, or dental, pharmaceutical and medical care are
> prohibitive government policies. It's as though resourcefulness and
> thinking for oneself are not allowed. One of our women said it
> succinctly: "I fought to get away from the control of an abusive husband;
> now I am controlled by an abusive system."
>
> ----------------
>
> I 'fess up. I've gone off on a rant. But I'm soooo angry. Every time I
> read about more money being spent here, there, anywhere but to addressing
> social and economic exclusion, I feel that much more disheartened.
>
> Chrystal Ocean, Coordinator
> Wellbeing through Inclusion Socially & Economically
> http://www.wise-bc.org/
>
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---
David Zitner, Director Medical Informatics
Dalhousie University Faculty of Medicine
5849 University Avenue #2L 16
Halifax, Nova Scotia B3H 4H7
902-494-3802 Fax 902-494-1642
Admin Support: Deirdre Harvey
[log in to unmask], 902-494-2234
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