health care costs

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Worried about rising expenditures for prescription drugs, many states are employing preferred lists to encourage doctors to prescribe older, lower-priced drugs and forego the latest, more expensive medicines.

If Congress succeeds in passing a Medicare prescription drug benefit this year, the debate over preferred drug lists - now raging in numerous states - is likely to explode onto the national stage.

The lists - also known as formularies - are, whether we like it or not, a form of rationing. Ask any Canadian.


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Six weeks ago, on this page, I lamented Roy Romanow’s failure to propose creative reforms to our country’s health care system. He simply demanded $15 billion more federal transfers to provinces, while expanding government monopoly into national homecare and a program to cover catastrophic pharmaceutical expenses. It’s not clear how he came up with the figure. Perhaps he just multiplied the $15 million cost of his Commission by one thousand?


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Faced with a crowd of 2,000 seniors protesting in front of the provincial legislature last Tuesday, the provincial government reneged on its commitment to a means test for Pharmacare benefits. This is a bad sign. Seniors currently pay a maximum 75 cents a day ($275 per year) for prescription drugs that are listed by Pharmacare, and taxpayers pick up the rest. If the government is afraid to take the baby step of means testing for Pharmacare, it is unlikely to make more significant reforms that are necessary to improve health care in British Columbia.