Report Finds ‘Significant’ Gaps in Ontario Healthcare

A new report finds that there is significant gaps to access Ontarios public health care system for certain groups By Laura BeestonStaff Reporter.
Thu., Oct. 13, 2016

Dr. Joshua Tepper, one of the lead authors of The Health Quality Ontario report, in his downtown office. The report found Ontario’s health public health system has “significant gaps” in care, and the inequalities are based on income, geography and education.

Mary and Brian Lewis on the front porch of their Hamilton, Ont. home on Oct. 12, 2016. The couple must pay over $600 monthly out of pocket for Brian’s prescriptions he needs following a stroke.

Aliçia Raimundo, a mental health advocate, has battled anxiety and depression since the age of 13. She pays out-of-pocket for her prescription medications, and counts herself “lucky” they aren’t more expensive.

Aliçia Raimundo said she feels lucky to only live with anxiety, depression and a thyroid issue, where her three prescriptions range from $30 to $90 a month.

Like nearly two thirds of Ontarians, the 27-year-old doesnt have public health insurance for prescription medication and so is paying out-of-pocket. As a mental health advocate, she says it is not uncommon for those with complex health issues to be spending hundreds of dollars a month on their prescriptions, or for them to go off meds they cant afford.

Inequity creates these holes in health care coverage, according to a report from Health Quality Ontario (HQO) released Thursday. The report looks at a range of complex points-of-access and the performance of the provinces public health care system.

Titled Measure Up 2016, it paints the picture of a province divided by geography and class, noting significant gaps in coverage for low income families, new Canadians and those living in poor and remote areas.

Income matters, said Dr. Joshua Tepper, president and CEO of the provincial advisory group, who is also a family doctor. It affects suicide rates, infant mortality, smoking, mental health issues and addiction.

When Ontarians are facing income challenges, the data shows they simply cant access care, said Tepper, leaving people sick and contributing to higher costs down the road.

The poorest people in our province have dramatically different access and outcomes measure after measure (and) to have the data is very important.

Tepper agreed that we are penny wise, pound foolish not to provide system supports that people expect around medications.

Economic barriers to accessing health care are an important aspect of health spending and overall system performance, the report noted, finding that prescription medication insurance disparities are based on income, education, and immigration status.

Ontarians who did not have prescription medication coverage most often fell into those groups, in addition to people living in poor neighbourhoods.

Hamilton resident Brian Lewis, 62, knows this well. He is on 12 different medications for complex health needs and hasnt been able to work for the past decade.

Our whole world fell apart after he had his stroke, said his wife Mary, 53, who suffers with fibromyalgia, depression and joint problems and is on three prescription medications.

As her husbands primary caregiver, Mary says shes worried 24/7 about his health and their poverty. Her daughter buys groceries to keep their cupboards from going bare.

For a time, Mary said, the couples pharmacist scrambled with pharmaceutical reps to find them free samples. Today, she cant imagine how theyd survive were they not on the Ontario Disability Support Program (ODSP), which currently runs out when Brian turns 65, after which he has to reapply. Their combined 15 medications would cost the couple $900 per month were they not covered.

It scares the hell out of me to think about a future where Brian is no longer eligible for ODSP, said Mary. I dont know what is going to happen. I dont know if his drugs will be covered.

Everybody should (get) the meds they need, to have the availability and affordability to get the health care they need, she added.

One of the fastest-growing expenditures, prescription drugs account for 16.6 per cent of total public health spending in Ontario, according to the HQO report. It found Ontario is the second-highest spender on prescription drugs among comparable countries, behind only the U.S.

In its tenth iteration, Measuring Up 2016 offers other big-picture takeaways about the complexity of Ontarios publicly funded health care system, too.

Some good news: Smoking and smoking-related illnesses are in decline; physical inactivity has improved and we have shorter wait times for surgery.

Some bad: Caregiver distress is on the rise; 65 per cent of palliative care patients die in hospitals instead of at home, which is their first choice; Ontarians dont eat enough fruits and vegetables.

There are also clear trends illustrating gaps in the quality of care for patients living with mental illness and addictions living in the poorest neighbourhoods, the report noted. Two million people are affected by a mental illness or addiction in Ontario, and it is among the top causes of disability nationally.

Poor Ontarians also had a significantly lower rate of follow up with a doctor after a mental episode and had the highest 30-day readmission rates to hospital.

So clearly, there are gaps to close.

Just because we lack a yearly income or are living in poverty doesnt mean we are any less of a person, or less deserving of health care, Mary said

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