Health Committee on Nov. 22nd, 2018

[Michelle Corcoran]

It doesn't matter which type of diabetes you have; all insulins are accessible for both type 1 and type 2.

There are long-acting insulins, short-acting insulins, and rapid-acting insulins. I'll give you some examples of long-acting insulins: Toujeo, Tresiba, Humulin N and Novolin NPH. They are long-acting insulins that give you coverage for an extended period of time, 24 hours or longer.

There are insulins that are short- or rapid-acting that you would take with a meal, based on what you are eating at a meal, the carbohydrate content or other factors, things like how well you are, whether you have exercised, or whether you have done anything else that could cause changes to your blood sugars. Those insulins give you the two different things.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Can either one be used with a pump?

[Michelle Corcoran]

No, the rapid-acting insulins are the only ones that can be used with a pump: Humalog, Apidra and NovoRapid.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

I'm guessing those are the most expensive ones.

[Michelle Corcoran]

No, they are not.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

That's interesting.

The next question, then, would be the cost. Victor, you talked a lot about the cost, and so did you, Louise. You're both type 1 diabetics. Are you applicants for the disability tax credit as type 1 diabetics?

[Victor Lepik]

Are you directing that to me?

[Tom Kmiec, Conservative, Calgary Shepard, AB]

We could start with you, Victor.

[Victor Lepik]

Am I eligible for the disability tax credit? No, I'm not. I applied for it, and I was refused.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

When were you refused?

[Victor Lepik]

That was probably within the last three or four months.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Were you informed that you had a right of appeal?

[Victor Lepik]

No, I don't recall that. I'll just ask my wife.

Did they say we had a right of appeal for that tax credit?

[A voice]

I'm not sure.

[Victor Lepik]

We're not sure, but I don't believe so.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

How about you, Louise?

[Louise Kyle]

I have never applied for the disability tax credit, partly on principle. I have never felt that my diabetes is a disability. I think that, as long as one has the proper tools to manage it, then it shouldn't be a disability, so I've never applied for it for that reason.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

So if there's a—

[Victor Lepik]

Could I just add something? When I asked my family physician to sign the form for this, he said, “We'll give it a go, but I don't think we'll have much luck”.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Did he explain why?

[Victor Lepik]

I vaguely remember it now, but I do remember him saying, when he filled out the form and gave the reasons for it, “Good luck, but I don't think we'll succeed with it”.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

CRA has been en masse refusing type 1 diabetics from having access to the DTC and also not informing people that they have a right of appeal, which is why I asked whether that is what you two have lived through in your experiences.

[Victor Lepik]

I understand.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

The University of Calgary has made a calculation that there are about 1.8 million Canadians who could apply for the disability tax credit, but only 40% do, and a lot of it is associated with stigma or not knowing about the DTC. A few of the groups that presented as witnesses before this committee mentioned that they don't promote it to the people with whom they interact.

It's worth for an adult with an average income of $45,000. You're talking about $7,600 a year off your taxes. In their case, that is a substantial amount of money. That's for the pump and lot of the things that go with it.

Thank you, Victor, for providing a lot of the costs associated with monitoring your condition and making sure you are healthy and able to have quality of life and be productive, too, to the level that you want. How much time does it take you in a week to take care of your condition?

[Victor Lepik]

One of the factors in the application for the tax credit was how much time it takes. I don't think they calculate into that or allow on that tax credit calculus the time it takes to check your finger prick 10 times a day and to change.... I don't use that system anymore, since I have the glucose monitor, so my time frame is much less in that respect, but the actual time it takes to monitor and look after your diabetes, especially with type 1, is 24 hours a day, because it can never, ever, leave your mind. My phone is always buzzing, and, my God, the thing I used to fear the most before I got a continuous glucose monitor was going to bed at night, because I would be stressed every night going to bed wondering if I was going to wake up or not.

The way they calculate it for the tax credit is actual physical this, that and whatever, but the mental stress is a 24-hours-a-day calculation that doesn't come into the equation whatsoever.