The Ontario Government has begun to implement OHIP+: Children and Youth Pharmacare. OHIP+ has been in the works since July 2017, when the Executive Officer of the Ontario Public Drug Program, Suzanne McGurn, revealed that the Ontario Government was proposing to amend the Ontario Drug Benefit Act.
As of January 1, 2018, anyone 24 years and younger who are currently covered by OHIP have access to all drugs currently offered through the Ontario Drug Benefit (ODB) program.
The ODB program currently covers 4,400 drugs. Some of the drugs included are antibiotics to treat infections, inhalers for asthma, antidepressants and oral contraceptives. Those who were previously enrolled in the program will continue to have the same coverage, but will no longer have to pay to get the drugs they need. Those who fall under the criteria of OHIP+ were automatically enrolled in the program.
If users of OHIP+ require a drug that is not a part of the ODB program they can, with the help of a physician, apply for coverage through the Exceptional Access Program. If the application is approved the drug will be covered in full.
Although some believe OHIP+ is a fantastic addition to public health care, there are many who are skeptical about it. OHIP+ is a $450 million-dollar initiative, yet it may not even be necessary. While the program will cover 1.2 million people who didn’t have drug coverage, they will also be covering 2.1 million children who were already covered by private insurance plans.
While it is helpful to provide drug coverage for those who need it such as senior citizens, those on social assistance or with prescription drug needs, many are confused as to why the government is using taxpayers money to provide coverage to individuals who do not need it.
“I actually believed and still believe that the NDP proposal to cover 120 drugs with strong evidence for all Ontarians was a better first step towards universal pharmacare,” says Michael Decter, a former Deputy Minister of Health and one of the country’s leading health care analysts.
Aidan Hibma, Vice-President, Finance and Administration of Brock University Students’’ Union, also sees the flaws in OHIP+. “I think it’s a good idea, I really like it, but obviously being on this side of OHIP+ I see more of the technical issues when it comes to individuals trying to make claims.”
Although Hibma is to leave office by the end of the school year, he has considered the potential impact OHIP+ could have on BUSU’s Student VIP Extended Health and Dental Plan. “So BUSU is really excited about the new OHIP+ rollout but realistically we don’t know how it’s really going to impact our Health and Dental coverage thus far,” says Hibma.
Hibma explains that in order to make the necessary decisions about the health plan, they must first collect and analyze data on prescription drug claims for the next few months.
“So, if there’s major decreases that means that over the summer months whoever steps into the new VPFA role is going to have that data to analyze,” says Hibma. He went on to explain that there are three likely possibilities for how the health care plan can change if there is a decrease. “The first option could be since we recognize that there aren’t as many claims, do we want to take that money and extend our coverage into other fields whether that’s vision or more specialty drugs. The second option is to expand the number of drugs available to students. The third option is to look at our contract with Student VIP who brokers with Blue Cross and what we can do then is decrease the rate that we charge students. It’ll be a huge judgement call for the next VPFA.”
Hibma thinks that if adjustments to the plan are made, they will be done between June and August so they can be in effect from the start of the new term in September.