Ontario Drug Benefit 2012: To Classify Wealthiest Seniors as New Five Per Cent in August 2014

You may have heard in the news about the one per cent social class as well as the 99 per cent social class. It’s my understanding that these statistical figures really apply to the US.

However, the Canadian figures in Ontario are slightly different and will soon include:

Five per cent of Canadian seniors as the wealthiest seniors
Plus three per cent of the remaining Canadian seniors are lower-income seniors
Plus 92 per cent of the remaining Canadian seniors
There are about 1.9 million seniors living in Ontario

Now, you can add the new five percent (and 95 percent) to the Canadian vernacular regarding social classes in Ontario, according to the following proposed changes to the Ontario Drug Benefit (ODB) program:

For Canadian seniors, a new five percent social class in Ontario will emerge in August 2014 as follows:
- Five per cent of seniors with the highest incomes and greatest ability to pay their own drug costs will pay more of their own prescription drug costs because they will pay the following new income-tested deductibles:
  - For single seniors with income of more than $100,000 the deductible will be $100 plus three per cent of net income over $100,000.
  - For senior couples with a combined income of more than $160,000, the deductible will be $200 plus three per cent of their family net income over $160,000.
  - These seniors will also continue to pay a co-payment of $6.11 per prescription after the deductible amount.
  - Income thresholds will not be indexed for inflation.
  - About 75,000 seniors will pay an average of $665 a year more towards their prescription drug costs.
- In order for the province to be able to invest in more home care and supports for all seniors:
  - This measure will save $30 million in 2014-15
  - and help the government better support an aging population
  - through a new Seniors Strategy which calls for
    - expanding house calls,
    - increasing access to home care,
    - and providing improved coordination between hospitals, primary and community care.

Drug costs for most seniors below these net income levels would remain the same. That is:
- 3 per cent of seniors who are lower-income seniors will pay less:
  - The $100 deductible will continue to be waived for lower-income seniors.
  - Lower-income seniors who currently pay the $2.00 co-payment will continue to pay $2.00 per prescription.
- and 92 per cent will be paying the same because they would not be affected by these changes in the Ontario Drug Benefit (ODB) program which:
  - helps all seniors with the cost of their prescription drugs
  - makes all seniors eligible for the ODB regardless of their income level
  - will not increase drug costs for seniors with net incomes below the $100,000 or $160,000 thresholds who already get drug benefits:
    - these seniors will continue to pay only the first $100 of their drug costs each year, plus a co-payment of $6.11 for each prescription after the $100 amount

Please click here to learn more details about the new income-tested deductible for prescription drug costs for high-income seniors.

What do you think?

Is this a fairer drug system for seniors?

Ontario, Canada: Newsroom

NEWS RELEASE

A Fairer Drug System For Seniors

April 2, 2012

McGuinty Government Taking Strong Action To Protect Health Care

Ontario is asking the five per cent of seniors with the highest incomes to pay more of their own prescription drug costs — so the province can invest in more home care and supports for all seniors.

The Ontario Drug Benefit (ODB) program helps all seniors with the cost of their prescription drugs. All seniors are eligible for the ODB regardless of their income level.

As proposed in the 2012 Ontario Budget, high-income seniors would pay a greater share of their drug costs starting August 2014:

For single seniors with income of more than $100,000 the deductible will be $100 plus three per cent of net income over $100,000.
For senior couples with a combined income of more than $160,000, the deductible will be $200 plus three per cent of their family net income over $160,000.

Drug costs for seniors below these net income levels would remain the same.

This measure will save $30 million in 2014-15 and help the government better support an aging population through a new Seniors Strategy which calls for expanding house calls, increasing access to home care, and providing improved coordination between hospitals, primary and community care.

Protecting health care for families and seniors is part of the McGuinty government’s Action Plan for Health Care and builds upon the gains made in health care since 2003.

QUOTES

“Our government is making the right choice to ask the wealthiest five per cent of seniors to pay more for their prescription drugs. This change will help us to invest in better health care in the community for our seniors and ensure the long-term sustainability of our health care system.”

– Deb Matthews
Minister of Health and Long-Term Care

“CARP has called for a comprehensive strategy to ensure a seamless continuum of care starting from a post-acute episode or diagnosis and continuing to end of life. The Ontario budget measures clearly recognize the importance and the preference of staying in one’s own home as long as possible in this journey, and the savings from the changes to the ODB can help achieve more extensive health coverage for Ontario’s seniors. Even with the proposed changes to ODB, Ontario seniors will be among the best-off compared to those in other provinces.”

– Susan Eng
Vice-President of Advocacy, CARP

QUICK FACTS

The ODB program helps about 1.9 million seniors in the community and 215,000 seniors and non-seniors living in long-term care homes or receiving home care services.
Ontario has reduced the price of most generic drugs to 25 per cent of the brand-name products, saving seniors and families more money on their prescriptions.
Ontario’s drug reforms are now saving the province $500 million a year – and this year will save an additional $100 million.
The 2012 Ontario Budget commits to a four per cent yearly increase in funding for community care over the next three years.