Again, across most of the country, seniors have coverage through public drug plans. As for seniors who have been in the workforce for a long time, this is not the entire seniors population, obviously, but a significant portion may still have access to the health benefits program in their place of employment even after they retire. This pertains particularly in the case of public sector workers, but not only public sector workers.
The issues for seniors are twofold. One is steps to ensure that there is appropriate use because this kind of over-prescribing has been described in some detail in front of the committee today. The other issue is, if there's a wish to move forward on universal coverage, what should the payment model be?
Right now, what seniors might pay is subject to a certain amount of income testing, but often the caps, the deductibles, the quarterly eligibility characteristics, and so on, don't necessarily take good account of relative income. As I mentioned, it's very difficult politically to imagine introducing higher co-pays, premiums, or something of that nature.
The reality is that we have some relatively well-off individuals over age 65 who are getting very good access to coverage for their drug costs, whereas that 30-year-old, I mentioned a few minutes ago, the single parent with a couple of children, making a very modest income, and with somewhat erratic employment in terms of regularity and access to employer-based benefits, may be getting no coverage at all.
One has to weigh up at the end of the day, is that really a reasonable way to approach an efficient coverage model in Canada?