Plan your medication while traveling

A federal election will take place in late October, when many people will plan their winter vacations. However, many of these “wintering tourists” may soon find themselves stranded on the ground.
Cach fall, few patients consult me to adjust their medication. Often, when I am about to increase a dose or add a new medicine to improve diabetes control, hypertension, etc., patients mention that they plan to leave for Florida, take a cruise or to go abroad in a few months.

I am fully aware that even a change in the dose of medication may make private travel insurance invalid and the move to a “close cousin” of the same drug family would undoubtedly have the same effect. I usually simply advise patients to more strictly adhere to their dietary restrictions until they return to Canada. But now, a larger category of patients, whose medication has been stable for several years, risks losing their insurance.

For several months, well-established drugs have suddenly been “out of stock” for an indefinite period. These include drugs used in cancer treatments and several medications for the treatment of hypertension, heart failure, diabetes, heartburn and seizures. Is this fact due to an increase in global demand, a lack of active ingredients, contamination problems, any manufacturing problems or simply a decision to stop the production of a drug that is not profitable? Nobody seems to want to answer that question. Health Canada is reporting 1848 drug shortages and 65 anticipated shortages.

A drug substitute can be from the same family and still have completely different side effects and reduced effectiveness. A forced change of medication three months before a trip can have disastrous economic consequences if it makes the patient “unstable” in the eyes of insurance companies. Doug Ford’s government plans to cancel health coverage for overseas patients starting Jan. 1, except for kidney dialysis patients. Patients are encouraged to simply purchase private travel insurance. But it will become more and more difficult for many.

Until coverage is canceled, Ontario pays $ 200 per day for ICU care and this amount can go up to $ 400 per day. It is still more generous than in many provinces.

Comparatively, for someone visiting from another province or territory, an Ottawa Community Hospital receives $ 1010 for a standard room and the Ottawa Hospital receives $ 1958.

The 2017-2018 Annual Report of the Canada Health Act states: “If insured persons stay outside the country, insured services must be paid at the rate of the province of residence.”

It should be noted that, buried in the report, is this sentence, which reads as follows: “In addition, with the exception of Prince Edward Island and the three territories, the daily rates set for services provided abroad seem to be lower. to those established for these services when they are provided in the province of origin, which is a requirement of the LCS transferability criterion. Unfortunately, while financial penalties for overcharging and user charges are “mandatory,” other violations, such as portability violations, are only “discretionary”. We also find in the report: “The Discretionary Penalty provisions of the Act have not been applied to date. ”

Quebeckers and other Canadians, but especially those who plan to leave the country for business or vacation, should demand that the federal Minister of Health investigate the cause of the growing shortage of drugs and find a solution. After many years of federal inaction, it should ensure once and for all that all Canadians enjoy full health coverage abroad as prescribed by the Canada Health Act. This is likely to result in a demand for increased provincial health transfer payments from the provinces. That’s why the next time federal, provincial and territorial ministers of health come together,

In the meantime, these elements should be issues in the next federal election.

Dr. Charles S. Shaver is a native of Montreal. He was formerly President of the General Medical Practice Section of the Ontario Medical Association. The opinions expressed in this article are his.

Local information matters to me and I want to participate in the future of my life.

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