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Life Off-the-Grid

The Prescription Drug Debate

By Cam Mather

Well I’m going to wade into the healthcare/prescription drug debate, which I believe is a pretty important discussion topic these days. The boomers are starting to retire and they represent a massive demographic bulge as they enter their high healthcare demand years. And they take a lot of drugs. Tons of them apparently.

Healthcare is starting to swallow government finances like Pac Man. Healthcare spending in the U.S. is 15% of gross domestic product (GDP). In Canada we hit almost 12% of GDP. The first scary thing to note is that as you age you use the healthcare system more and more. In Canada those under age 64 average about $2,000 per person a year. Those between 65 and 69 average $5,589, and for those 80 and older use an average of $17,469 worth of healthcare a year! Ouch. So our healthcare costs are already skyrocketing and the healthcare system is about to be ambushed by the boomers.

Here’s a statistic from a recent issue of Macleans Magazine that really blows me away. The Canadian Institute for Health Information recently found that two thirds (66%) of Canadians over 65 use five or more classes of prescription drugs. FIVE! One fifth (20%) of Canadians use 10 or more classes of prescription drugs. (from http://www2.macleans.ca/2010/04/12/the-health-care-time-bomb/)  I am not a doctor but it seems to me that’s just crazy. How could 10 drugs possibly work when they’ve got so much competition from other drugs? Wouldn’t you get side effects on top of other side effects? And wouldn’t you end up having to take other drugs to deal with the side effects?

I just don’t understand when sickness became the norm. How did we survive a few decades ago before prescription drug use became so prevalent? I don’t think people really need this many drugs, I just think it’s becoming what “we” do. Doctors aren’t helping the issue, because they write the prescriptions. Maybe it’s faster to get patients out of their offices to just write a “script”. And patients probably aren’t helping. Watching the major network newscasts is now just one big prescription drug commercial. One after the other. “Ask your doctor about…” is the common refrain. When people keep asking for them, maybe doctors take the path of least resistance. Now the ads all claim they’ll provide your first prescription for free. Sounds like a crack dealer trying to get you hooked.

Our family has been blessed with good health and we have rarely needed prescriptions. I think our last one was about 18 years ago when my daughter was young and had an ear infection. My 98-year old grandmother doesn’t take prescription drugs. When my cousin takes her to a rare doctors’ appointment, the biggest challenge seems to be convincing the person who is filling out the doctor’s paperwork that she doesn’t take drugs. It doesn’t matter how you ask it, she’s not on any prescriptions. It is possible. I understand that as we get older some things are not going to work so well, but at what point do we hit a diminishing return on prescriptions? 3 drug classes? 5? 7?

In 2003 George Bush enacted the Medicare Prescription Drug, Improvement, and Modernization Act (also called the Medicare Modernization Act or MMA) which funds most drugs for seniors and costs the U.S. Government billions of dollars each year and added trillions of dollars onto its ‘un funded liabilities.” Here in Ontario the Drug Benefit Program pays for all your drugs when you turn 65. Forgive me if I sound like a hardass here, but there is no incentive NOT to take drugs once you turn 65. According to the Macleans article that I read, prescription drugs are the fastest growing component of skyrocketing health care costs. Ya think? Why not? THEY’RE FREE! There is a disincentive to be healthy in a system that gives you drugs for free. I just read another statistic that only 15% of Ontarians actually pay out of pocket for their prescription drugs! Eight-five percent of people in Ontario are covered by a drug plan through their job or through a government plan. (Perhaps the fact that I am one of the 15% who would have to pay out of pocket is one of the reasons we’ve used them so rarely.)

Now that these benefits have been provided they will be next to impossible to remove. At least not as long as we’re going with the “business as usual” model. I would suggest that this condition won’t last forever, and when these benefits go away, many other government programs will as well. So buy a bike, start walking, eat your green leafy vegetables and start getting enough sleep. Staying healthy and not needing drugs is going to be a good strategy in the future.

Ontario's Healthcare Costs are Skyrocketing

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1 Comment

  1. Janet Webb

    Ok being one of those drug prescribing doctors you know I have to respond. First of all alot of things have changed in the last 70 years really with the advent of penicillin. In the “good” old days, if you survivied past age 5 and didn’t succumb to one of the childhood illnesses that we now vaccinate against, you could expect to live to about 62 and then you usually died suddenly of a heart attack or pneumonia or something else that we had no treatments for. Of course if you were a woman you had a good chance of dying in childbirth. These same patterns are still present in 3rd world countires. Today the average life expectancy is 82 for men and 84 for women and expected to increase in the future. The problem is that doesn’t mean that they don’t have illnesses most of which start ot peak in the 60’s and 70’s. Now we can treat your heart attack or lung infection but you are now left with a chronic disease that doesn’t go away but can be somewhat ameliorated by the those nasty meds. Lifestyle of course does make a difference as does education level, socioeconomic status and genetics. However for most of the baby boomers if they already haven’t been doing this they probably already have a chronic illness – are we supposed to not treat them? You could argue that drugs like antidepressants and viagra are not really necessary but again if you happen to have one of these things befall you they can be fairly horrendous and make you unable to function properly (no pun intended) in society.

    The reality is that the progress of medicine has allowed us to treat chronic diseases and allow longer lives (diabetes, heart disease, lung disease etc) but the trade off is the use of multiple medicines. The myth out there is that we can “cure” illnesses. Other than a few acute things such as infections and some surgeries such as appendectomy we cure very little.

    Finally don’t blame the doctors. We spend alot of time in the office advocating lifestyle changes and trying to change or influence our patients behaviours. It is definitely and uphill battle.

    See you Sunday at the indian dinner night.

    Janet

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