Thursday, December 27, 2018

Front-and-centre nutrition alert labels on the way

Health Canada's food labelling proposals should help Canadians deal with an epidemic of obesity and diet-related chronic diseases

By Fabio Gomes
Fabio Gomes
Fabio Gomes
Supermarkets are crowded with around
40,000 products, yet most shoppers spend fewer than 10 seconds selecting an item. That's certainly not enough time to review current Canadian nutrition labels, which are on the back or side of packages and contain detailed information that's often too complex for many consumers to understand.
But nutrition labeling is about to change in Canada. That's good news for our health and for informed consumer decision-making.
Health Canada is developing new "high in" nutrition alert labels for the front of food packaging. This is consistent with best practices and evidence of how to provide consumers with quick and easy information about the levels of saturated fats, sugars and/or sodium in food and drink products.
How does it work?
When a product has more than a specified level of certain nutrients, it must have a prominent black label on the front of the package that says simply, depending on the nutrient in question: "high in sugar," "high in fat" or "high in sodium." There are no numbers or symbols that require further interpretation.
Importantly, the simple but powerful words "Health Canada/Santé Canada" should also be on the label to convey that the alert symbol has legitimacy and authority.
This is an excellent step forward and will make Canada the first G7 country to mandate such labelsif the plan proposed by Health Canada is approved and implemented.
Why did Health Canada choose this option?
Research, including work awarded the Nobel Prize, has consistently demonstrated that consumers don't spend a great deal of time and effort in purchasing situations, especially when it comes to repetitive decisions, which is the case when buying food. Current nutrition facts, unfortunately, don't sufficiently influence shoppers' choices towards healthier products.
Why is this the case?
Because food and drink nutrition labels are frequently difficult to find, hard to read and obscured by competing claims on the packaging.
There are often prominent but misleading claims by manufacturers on the front of the packages that may be at odds with the nutrition label on the back. Images of natural foods, such as fresh fruits and cartoon characters, as well as colourful designs, can also distort consumer perceptions about certain foods.
A good nutrition label needs to cut through the hype.
The key to an effective front-of-package labelling system is that it must be both simple and interpretive. Simple means that it shouldn't require that the consumer have any nutritional knowledge for the label to be understood. Interpretive means that information should be given in the form of guidance to the consumer, rather than simply providing numbers.
Consumers invest little time in making a purchasing decision, so the system has to also facilitate quick recognition and processing of the information.
Various other promising front-of-package labelling systems have been developed to help consumers make better food choices. Some involve traffic lights - green, yellow and red to indicate low, moderate or high levels of nutrients. Others use numbers and percentages to depict the level of nutrients, and some use stars - the more stars, the healthier.
But research has generally found that these systems are not as effective at helping consumers steer away from foods that are "high in" sodium, sugar or saturated fat. And these ingredients are linked to the diseases that are the major causes of death and loss of years of healthy life in Canada, such as cardiovascular diseases, cancer and diabetes.
Health Canada was also able to rely on international experience when making its decision. The "high in" labelling approach is used in Chile, and approved for use in Peru and Uruguay.
Evaluation of the first year of use in Chile shows that 93 per cent of Chileans reported they understand the labels and 92 per cent found it influenced their purchasing decisions. Manufacturers may also be improving the nutritional content of their products to avoid the negative labels. Food manufacturers in Chile reformulated 18 per cent of their products prior to the implementation of the labelling system in order to avoid having the label on their products.
Canada and many other countries face an epidemic of obesity and diet-related chronic diseases with serious and expensive health consequences for individuals and societies. Front-of-pack "high in" nutrition labels will help consumers make healthier and more informed food choices.
Dr. Fabio da Silva Gomes is an Advisor in Nutrition and Physical Activity with the Pan American Health Organization/ World Health Organization and a Contributor with based at the University of Winnipeg.

Friday, December 21, 2018

Holiday Peppermint Smoothie

Peppermint can reduce headaches and help you feel rejuvenated. And this smoothie makes a tasty alternative to eggnog. Garnish it with a pretty rim of crushed candy cane.

11/2 cups (375 mL) skim milk
11/2 cups (375 mL) low-fat vanilla yogurt 
11/2 cups (375 mL) ice cubes
5 peppermint leaves, torn
1 Tbsp (15 mL) ground cinnamon 
A few drops peppermint extract (optional)
Blend all ingredients and serve in cups garnished with a pretty rim of crushed candy cane.

Serves four.
Per serving: 114 calories, 8 g protein, 1 g fat (1 g saturated fat), 19 g

Chocolate Almond Smoothie

Thursday, December 20, 2018

Let's make Canadian hospitals more senior-friendly Hospitals need to identify vulnerable patients with complex needs so they can quickly address and minimize complications (FREE)

By George Heckman
and Paul Hébert
Canadians are living longer. Unfortunately, our hospitals aren't ready for them.
Canadians over 65 years old use more than 40 per cent of hospital services, a demand that continues to rise.
But as they age, Canadians hope to stay at home as long as possible.
George Heckman
George Heckman
If hospitalization is required, they should expect to go home quickly and safely afterwards. Yet many spend weeks to months in a hospital bed, acquiring new health problems and disabilities, only to find themselves among the more than 300,000 Canadians living in nursing homes.
If hospitals are meant for getting well, why does this happen?
Our health-care system was designed in the 1950s and focused on hospitals. Back then, it was about unexpected emergencies, like pneumonia or injuries. Conditions like heart attacks had few beneficial treatments, so most patients didn't survive very long.
Today, advances in medical science and public health mean that more people survive with conditions that would have killed their grandparents. Conditions that can be treated but not cured are called chronic diseases. The biggest risk factor for chronic diseases is aging. As Canadians get older, they usually acquire not just one but many chronic diseases.
Many older Canadians also develop other age-related problems such as dementia, making simple everyday tasks more difficult. Many lose muscle strength, becoming less active and more disabled.
Over time, the burden of these problems grows and affected persons become increasingly vulnerable. Simple health challenges like influenza, nothing more than a nuisance to young people, will incapacitate or kill a vulnerable older person. This vulnerability is called frailty.
Paul Hebert
Paul Hebert
The problem is that hospitals remain better suited to care for healthy surgical patients and acute illnesses like pneumonia. Most aren't geared to helping frail seniors cope with acute illnesses or flare-ups of chronic conditions. Frailty is why so many do poorly in senior-unfriendly hospital environments, often becoming more confused and disabled, often irreversibly.
What can be done?
First, hospitals need to identify vulnerable patients with complex needs so they can quickly address and minimize complications. Detection requires that the right information be collected efficiently and reliably at the right time.
Ideally, information about complex needs and frailty should be identified early, in all health-care settings, using a common approach. That would mean that important information can be gathered and acted upon even before a hospitalization. Most of the pieces for this approach are in place in Canada but not in hospitals. Existing hospital documentation systems are bloated and inefficient, collecting some information repetitively but missing other important data.
Yet knowing who's at risk ensures that patients with mobility issues don't stay bedridden a minute longer than needed. It means that patients with dementia are regularly oriented to place and time, and maintained on a stable daily routine. It means aggressive de-prescribing programs to get rid of harmful or useless medications. It also means a more efficient health-care system.

An international not-for-profit group of researchers called interRAI has carefully designed and studied instruments for just this purpose. Its assessment tools are already used in home care, nursing homes and mental health settings across Canada. Unfortunately, they aren't used yet in primary care and hospitals, where measuring frailty is typically an afterthought, if done at all.
Along with colleagues, we recently studied the interRAI Hospital Suite used in 10 Canadian hospitals on over 5,000 older adults, supported by the Canadian Frailty Network. The instruments were easy to use and reliably predicted, within 24 hours of hospitalization, which older patients would develop complications in hospital, which were at risk of a long hospital stay and which were at risk of ending up in a nursing home.
Efforts are already under way to make our hospitals senior friendly, but the lack of systematic assessment in the system overall leaves us all vulnerable as we age. By the time frail patients need hospital care, it's often too late to address their complex needs.
Reliable information is a fundamental requirement to make our health-care system and especially our hospitals senior friendly, allowing better targeting of programs to respond to needs along the entire trajectory of life.
Dr. George Heckman is the Schlegel Research Chair in Geriatric Medicine and an associate professor at the University of Waterloo, and an assistant clinical professor of Medicine at McMaster University. He is an interRAI Fellow, a researcher with Canadian Frailty Network, and a contributor with Dr. Paul Hébert is a senior scientist at the Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and a full professor in the Department of Medicine of the Université de Montréal. He is also a researcher with Canadian Frailty Network and a contributor with

Tuesday, December 18, 2018

Trooper Black Eyeliner Obsession

 A limited-edition vault which features five of Kat Von D's long-wear, high-pigment liquid eyeliners. 
Available at Sephora, $110.00 CAD

Monday, December 17, 2018

Butternut Squash + Sweet Potato Soup

Butternut squash, pear, and sweet potato blend well together and make a filling low-calorie soup you'll savor.
3 slices center-cut bacon, chopped
3 leeks, white and light green parts only, chopped, 2 cups
2 pounds butternut squash, peeled, seeded, and chopped
1 pound sweet potatoes, peeled and chopped
2 pears, peeled, cored, and chopped
2 carrots, chopped, ½ cup
1 teaspoon chopped fresh thyme
⅛ teaspoon ground nutmeg
4 cups lower-sodium, fat-free chicken broth
½ cup light cream
¼ teaspoon salt
⅛ teaspoon ground black pepper

1. Heat a large saucepan over medium-high heat. Add the bacon and cook until crisp, 5 to 6 minutes. Stir in the leeks and cook until they start to soften, 2 to 3 minutes. Add the squash, sweet potatoes, half of the pears, the carrots, and thyme; cook, stirring occasionally, until the vegetables are slightly softened, about 9 to 10 minutes. Stir in the nutmeg and cook for 30 seconds. Pour in the broth; bring to a boil, reduce the heat to medium-low, cover, and simmer until the vegetables are tender, about 30 minutes. Remove the saucepan from the stove and cool for 10 minutes.
2. Transfer the soup, in batches, to a blender and puree. Return the soup to the saucepan over medium heat. Stir in the cream, salt, and pepper and heat until hot, 1 to 2 minutes. Divide the soup among 8 bowls and garnish each with some of the remaining pear.

Friday, December 14, 2018

Common surgical knee procedure doesn't provide much benefit

A growing body of research shows that most older adults will get the same long-term outcomes from less invasive treatment

By Eric Bohm
and Ivan Wong
Nearly half of Canadians aged 65 and over experience osteoarthritis in their knees. Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage on the ends of bones wears down over time leading to pain, stiffness and decreased mobility. It frequently occurs in the hips and knees - and can be quite painful.
To help improve mobility and treat joint pain, it has been common for older adults with osteoarthritis of the knee to be referred to an orthopedic surgeon, like us, for a knee arthroscopy.
Eric Bohm
Eric Bohm
As orthopedic surgeons, we want to ensure that our surgical procedures provide high-value care to patients and do more good than harm. Unfortunately, this is often not the case for knee arthroscopy in older adults with arthritis.
Arthroscopy of the knee for arthritis involves making several small cuts to insert a small camera and instruments to view the joint and trim loose cartilage and wash the joint out.
Now there is a growing body of research showing that this procedure may not be necessary for most older adults since it usually has the same long-term outcomes as non-operative and less invasive treatment.
Alternative treatments can include weight loss, physiotherapy, exercise, over-the-counter pain medicines such as Tylenol, anti-inflammatories and pain-relieving joint injections.
Knee arthroscopy, on the other hand, is a surgical procedure that typically requires spinal or general anesthetic; there's always a risk of infections or structural damage to the joint.
Does this mean that all arthroscopy shouldn't be performed?
No. Rather, arthroscopy needs to be done for the right conditions and on the right patients. For example, meniscus repair surgery for a younger person with a knee injury can help improve function, treat pain and increase mobility.
What's at stake?
Ivan Wong
Unnecessary surgeries mean that our time as surgeons, as well as health-care system resources such as operating rooms and staff, are tied up doing surgeries that don't add much value to Canadian patients. These resources could be directed towards other orthopedic procedures that provide pain relief and improved function yet have long waiting lists, such as spine surgery and hip and knee replacements.
For older patients with osteoarthritis in the knee, arthroscopy is more often than not the wrong choice.
As surgeons, we advise our patients on alternatives to surgery and reflect on our own practice habits. We're also championing the Choosing Wisely Canada campaign to our colleagues and patients far and wide. Recently, the Canadian Orthopaedic Association, the Canadian Arthroplasty Society and the Arthroscopy Association of Canada joined to release a set of recommendations on best practices.
The first recommendation is against arthroscopy for initial treatment and management of osteoarthritis in the knee.
It's well established that physicians tend to overestimate the benefits of our procedures and often underestimate harms. Recent research shows that the same misconceptions about harms and benefits of common procedures are held by patients.
A culture shift is needed for surgeons, patients and the public on treatment expectations for knee osteoarthritis. Saying no to arthroscopic surgery, and instead undertaking non-operative management, is a challenge for clinicians and patients alike.
Thoughtful, evidence-based utilization of our health-care resources will help to improve appropriate care for all Canadians.
Dr. Eric Bohm is a professor at the University of Manitoba and an orthopedic surgeon with the Concordia Joint Replacement Group in Winnipeg. He is also a contributor with, which is based at the University of Winnipeg. Dr. Ivan Wong is an associate professor at Dalhousie University and an orthopedic surgeon at the QEII Health Sciences Centre in Halifax. He is also the president of the Arthroscopy Association of Canada.

Wednesday, December 12, 2018

Perfect Cranberry Sauce Recipe | Food Network Kitchen | Food Network Food Network

Empty a 12-ounce bag of fresh or frozen cranberriesinto a saucepan and transfer 1/2 cup to a small bowl. 

Add 1 cup sugar, 1 strip orange or lemon zest and 2 tablespoons water to the pan and cook over low heat, stirring occasionally, until the sugar dissolves and thecranberries are soft, about 10 minutes.

Tuesday, November 27, 2018

Life Made Delicious - Festive Recipes

1 can Pillsbury* Crescents
1 large round Brie cheese

1 egg, beaten
  • STEP 1 - Heat oven to 350°F. Unroll dough and separate into 2 sections; firmly press perforations, forming 2 squares.
  • STEP 2 - Place 1 square on ungreased baking sheet. Place cheese on centre of dough. Place second dough square on top of cheese round; press around cheese and seal completely. Brush with beaten egg.
  • STEP 3 - Bake 25 to 30 minutes or until deep golden brown. Cool 15 minutes before serving.

Tuesday, November 20, 2018

Corn infected with toxic mould reaches “catastrophic” level

 Posted  in Front Page | News

The corn harvest along Kimball Road at a Parkland Farms field.
Troy Shantz
This fall has brought a perfect storm to Lambton County’s corn farmers.
The cool, wet weather since August has sparked an outbreak of vomitoxin that’s made some corn harvests here and across Southern Ontario unfit for consumption.
In high concentrations vomitoxin, which is produced by mould, is harmful to humans and livestock, said Don McCabe, the Lambton-Middlesex director for the Ontario Federation of Agriculture.
It’s forcing farmers to sell their yields at a heavy discount, if they can sell it at all.
“Farmers are taking a massive hit in revenue,” said McCabe. “All corn farmers are going to be affected by this.”
The Grain Farmers of Ontario sent an open letter to its 28,000 members last week saying the outbreak of the vomitoxin, called deoxynivalenol, or DON, is one of the worst it has ever seen.
“We consider this issue at a catastrophic level at this point and it is only getting worse,” the letter states.
Even ethanol producers like Sarnia’s St. Clair ethanol plant are hesitant to take heavily infected corn, McCabe said. Though it doesn’t impact the ethanol itself the by-product producers sell as livestock feed is toxic.
Corn loads that test positive for vomitoxin are discounted from 5% to 50% off the contracted price, depending on the level of vomitoxin detected.
The full extent of damage won’t be known until harvest is complete, McCabe said.
“It’s all over the county.”
Lambton County farmer Mark Lumley isn’t a fan of the way corn is evaluated using a test he calls subjective.
He said area farmers are averaging two to three parts per million of vomitoxin, a levels experts say is safe and lower than what’s showing up in some areas, he said.
“They suck about a cup full of corn from a 40-tonne truckload… grind it with a coffee grinder, add water and put in a strip of sensitive paper,” he said.
The colour the paper turns is supposed to determine the level of vomitoxin in the entire load.
“They’ve devised a discount schedule based on this subjective, highly variable and unrepresentative and unverifiable test,” he said.
“It’s unregulated by any third party like the government or grain commission.”
Lambton County has 122,000 acres in corn production and is among the top four corn producers in Ontario.

Tuesday, November 13, 2018

Gay Lea Foods- Shortbread Bliss

Classic shortbread recipes bring bliss this holiday season

– Canadians have come to love shortbread as a classic holiday tradition, yet they are always looking for new, delicious and easy recipes for their holiday dessert trays. To provide Canadians with new ideas, Gay Lea Foods, the shortbread expert, has two new recipes that are sure to add to the joy of the holiday season.

“With more men spending time in the kitchen, we believe that both sweet and savoury shortbread will be popular this holiday season,” says Bernard Yeung, product manager at Gay Lea Foods. “Using a superior quality butter, like Gay Lea, will ensure the ultimate taste and texture for all your shortbread favourites.” Both recipes can be prepared in advance and will be sure to delight both friends and family:

Banana Coconut Cream Stacks Chipotle and White
Banana Coconut Cream Stacks

• Banana Coconut Cream Shortbread Stack – Bring the retro back to your kitchen with these sensational holiday cookies. Layers of shortbread, filled with blissful custard and bananas, make this a delight your guests will love.
Chipotle and White

• Chipotle & White Cheddar Shortbread Cracker– A twist on the classic shortbread cookie, this savoury treat with a spicy kick is something both men and women alike will be excited to prepare and serve. These piquant shortbread crackers are easy to make, slice and bake and are a delicious accompaniment for wine or beer.

For more recipe ideas, expert shortbread tips, and a chance to win exciting prizes, visit

About Gay Lea Foods

Made with cream from Ontario cows, Gay Lea butter is a homegrown natural choice for all your holiday baking. Established in 1958, Gay Lea Foods Co-operative Ltd. is Ontario’s largest dairy co-operative. Owned and operated by more than 1,200 farmers, it is a leading Ontario manufacturer and distributor of dairy products to retail, industrial and foodservice markets. Committed to delivering Ontario consumers the highest quality products, Gay Lea Foods is the proud producer of Gay Lea Butter, Gay Lea Real Whipped Cream, Gay Lea Sour Cream, Nordica Cottage Cheese, Lacteeze lactose-reduced milk and Ivanhoe Cheese. Visit for more information.

Wednesday, November 7, 2018

Intouch Insight Adds Internet of Things (IoT) Capabilities to Its CX Solutions

Intouch Insight announces that it has added Internet of Things capabilities to its suite of customer experience management products and services to help brands gain deeper location-level insights and drive customer experience improvements

OTTAWA, Canada, Nov. 7, 2018 /PRNewswire-PRWeb/ -- Intouch Insight Ltd. ("Intouch") (TSXV: INX) (OTCQB: INXSF) today announced that it has added Internet of Things (IoT) capabilities to its suite of customer experience management (CEM) products and services. Intouch will use sensors and other devices to help location-based businesses collect real-time contextual data such as temperature, sound, and traffic, and identify how these elements impact purchase behavior, customer satisfaction and overall customer experience.
Location-based industries such as restaurant, retail, finance, and healthcare will gain tremendous value by leveraging Intouch IoT capabilities in their customer experience programs. All data collected through location sensors will be pulled into the Intouch reporting platform in real-time and compared with customer experience and sales data. Automated key driver analysis will identify which location conditions drive things like poor customer experiences and missed in-store sales opportunities, empowering businesses to make improvements to the physical environment of each location to deliver better experiences.
"At Intouch, our vision is Perfect Information. Instantly. Our new IoT capabilities help us deliver on this promise in an innovative new way by providing our customers with real-time intelligence that helps them understand how contextual data correlates to business outcomes like revenue, profit, upsell rates and customer satisfaction. This value equation is significantly enhanced with our Action Campaign™ technology, which provides both management and frontline employees with the data and tools to take action and measure the impact on business outcomes," said Ravi Puvan, VP Product Management, Intouch Insight.
For more information on Intouch Insight's new IoT capabilities and how contextual data can be used to help improve customer experience visit:
About Intouch Insight
Intouch Insight offers a complete portfolio of customer experience management (CEM) products and services that help global brands delight their customers, strengthen brand reputation and improve financial performance. Through its flagship SaaS product, LiaCX™, Intouch helps clients collect and centralize data from multiple customer touch points, gives them actionable, real-time insights, and provides them with the tools to continuously improve customer experience. Founded in 1992, Intouch is trusted by over 300 of North America's most-loved brands for their customer experience management, customer survey, mystery shopping, mobile forms, operational and compliance audits, and event marketing automation solutions. For more information, visit
Certain statements included in this news release contain forward looking statements, which by their nature are necessarily subject to risks and uncertainties and other factors that may cause actual results, performance or achievements of the Company to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements. Such statements reflect the Company's current views with respect to future events, and are based on information currently available to the Company and on hypotheses which it considers to be reasonable; however, management warns the reader that hypotheses relative to future events which are beyond the control of management could prove to be false, given that they are subject to certain risks and uncertainties.
Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.
For further information, please contact:
George Aizpurua
Vice President, Communications
First Canadian Capital Corp.
Tel: 647-500-2389/416-742-5600
George Pretli
Chief Financial Officer

SOURCE Intouch Insight

Friday, November 2, 2018

HyVIDA, the First Hydrogen-Infused Sparkling Water, Launches in Giant \ Martins

HyVIDA Brands, Inc., producer of the World's first Hydrogen-infused sparkling waters, announces a partnership with GIANT Food Stores, LLC, compromised of GIANT and MARTIN'S neighborhood supermarkets located in the Mid-Atlantic region.

MUSKEGON, Mich., Nov. 01, 2018 /PRNewswire-PRWeb/ -- HyVIDA Brands, Inc., producer of the World's first Hydrogen-infused sparkling waters, announces a partnership with GIANT Food Stores, LLC, compromised of GIANT and MARTIN'S neighborhood supermarkets located in the Mid-Atlantic region. HyVIDA will be offered in more than 150 GIANT/MARTIN's locations.
"We are especially proud to partner with GIANT/MARTIN'S and its parent company, Ahold Delhaize," says Rick Smith, President and CEO of HyVIDA. "The company's recent pledge to remove all artificial ingredients, colors, or harsh chemicals in their own products is on point with HyVIDA's mission to create and deliver innovative, healthy beverages."
As one of the newest, fast-growth startups in the sparkling beverage industry, HyVIDA, launched on Amazon in May 2018, and has since added hundreds of independent, natural, and specialty retailers across the Northeast and Midwest regions.
HyVIDA's Hydrogen-infused sparkling water is the first of its kind due to its antioxidants properties, zero calories, and no sweeteners. HyVIDA is available in three varieties: Pure, Raspberry, and Lemon Lime.
"Hydrogen is a powerful antioxidant that has been proven in more than a thousand scientific studies to have a significant, positive impact on the mind and body," says Smith. "Hydrogen is the smallest molecule in the universe, and as a result, HyVIDA's infused Hydrogen and added magnesium electrolytes deliver significant functionality and an extremely smooth bubbly taste experience."
GIANT Food Stores, LLC is comprised of over 170 GIANT and MARTIN's neighborhood supermarkets, focused on offering transparent, healthy, product options.
For more information on HyVIDA, visit: For digital press kit items, visit:
About HyVIDA Brands Inc.
HyVIDA Brands is an early-stage, award-winning beverage company that is pioneering Hydrogen Infused Sparkling Waters and related beverages that offer healthy lifestyle benefits due to hydrogen's unique antioxidant properties.
Launched in 2018 by experienced medical technology entrepreneurs, both the HyVIDA headquarters & research facility are located in Muskegon, Michigan. HyVIDA has a robust intellectual property portfolio including multiple patent applications and trade secrets that enable low-cost highly scalable hydrogen infused beverages.
In partnership with Cascadia Managing Brands, HyVIDA is selling its RTD beverages in the natural, specialty, and e-commerce sales channels. For more information, visit:

Tuesday, October 23, 2018

Before implementing national pharmacare, look at what provinces already offer

Instead of using scarce health-care dollars broadly, we should identify and support those Canadians falling through the cracks

By Bacchus Barua
Associate Director
Centre for Health Policy Studies

The Fraser Institute
Bacchus Barua
Bacchus Barua
Modern medicines can improve health outcomes and quality of life for those stricken with illness. As a result, policy-makers and ordinary Canadians are understandably concerned about patient access, affordability and insurance coverage for prescrip­tion drugs.
However, recent calls for a national pharmacare program would have many believe that Canadians without private drug insurance - about one-third of the population - are out of luck.
Fortunately, this is far from the truth. There actually exists a vast network of provincial plans to help Canadians - particularly those who may be at higher risk of forgoing prescriptions due to financial considerations - pay for their prescription medications.
Perhaps most crucially, recipients of social assistance have drug coverage at very low or no cost in every province. And provincial governments across Canada also cover the severely disabled and those diagnosed with conditions such as multiple sclerosis and cystic fibrosis.
But most provinces go even further and ensure that most seniors and lower-income individuals and families with high drug costs don't face undue financial pressure.
For example, British Columbia helps cover the cost of prescription drugs for residents through a number of drug plans. The province's largest plan, Fair PharmaCare, covers 70 per cent of the cost of eligible pre­scription drugs for families with a net income less than $15,000. Once a family spends approximately two per cent of its net income on drugs or related costs, the province pays for 100 per cent of any subsequent costs for the rest of the year. The plan also covers families with higher incomes but requires them to first pay for their drug costs (up to two or three per­ cent of their income) before provincial coverage kicks in.
In addition, B.C. maintains specific plans for individuals with HIV, certain psychiatric conditions and palliative care patients, among others.
Ontario operates three principal drug programs: the Ontario Drug Benefit Plan (for seniors), the Trillium Drug Program (an income-based plan for all Ontarians) and OHIP+ (for children and youth). The plan for seniors covers residents over 65, plus those living in long-term care or special care homes, Ontarians on social assistance and those with disabilities. Those eligible for the plan pay very low amounts up front (ranging from zero to $100) before coverage begins, after which only small co-payments (ranging from $2 to $6.11) are required.
Like B.C., Ontario also covers the cost of some medications for people with specific medical conditions such as cystic fibrosis, HIV infection, anemia, age-related macular degeneration and inherited metabolic disease.
Quebec takes a unique approach by mandating all residents not covered by private group insurance to enrol in the government's drug insurance plan (RAMQ). Participating individuals pay premiums that range from zero to $616 per year, depending on family income. Individuals must pay the first $19.90 of drug costs out of pocket, then they only pay 34.9 per cent of the cost of eligible drugs up to a monthly maximum of $90.58 (after which all costs are covered).
However, the premiums along with the deductibles and co-pays are waived for a host of groups, including Quebecers on social assistance, children under 18, full-time students and persons with a functional impairment. In fact, 1.4 million Quebecers pay no annual premium (39 per cent of beneficiaries) - 900,000 of which are not required to make any direct contribution for their medication.
More generally across the provinces, lower-income Canadians have access to some form of provincial insurance that helps limit out-of-pocket costs to a small percentage of income for prescription drugs, if not more extensive coverage.
That being said, there's evidence that some Canadians may struggle to cover the costs of their prescription medications. One study recently estimated that one of every 12 Canadians (8.2 per cent) who required a prescription in 2016 had difficulty paying for it. If true, policy-makers should first identify these Canadians and help with the costs of their medications.
Somewhat bizarrely, however, the current prescription seems to be a national single-payer pharmacare program that would use scarce health-care dollars to subsidize everyone, including the majority of Canadians who likely don't need it.
Instead, we should help Canadians understand the coverage already available, and identify and support those Canadians falling through the cracks.
Provincial governments should remain able to tailor drug plans to address the needs and preferences of their populations.
A decentralized system also better fosters different experiences in each province, which makes it possible to better assess what works and what doesn't.
This dynamic may be lost with a national pharmacare program.
Bacchus Barua is associate director of the Centre for Health Policy Studies at the Fraser Institute.