Sara Allin, University of Toronto

1. What if social insurance could pay for prescription drugs? Sara Allin Report co-authors: Mark Stabile andCarolyn Tuohy

2. What is the problem? Unlike most high-income countries, prescription drugs are not universally covered under the health care system in Canada Why is a medically necessary form of healthcare publicly insured in hospitals, but not otherwise?

3. Possible policy option? Raising revenues through a social insurance model could be a possible way to achieve universal coverage of prescription drugs

4. What is social insurance? A method of raising revenue Contributions are usually related to salaried wages (and are always independent of risk) Contributions may be shared between employers and employees Revenue is earmarked for health care Collection agent is usually arms length from government Participation is mandatory (for the population or specified groups)

5. What are the potential benefits? A universal system addresses equity concerns arising from the current fragmented financing model Increased transparency with links between revenues and benefits could be more politically acceptable than general tax increases A diversification of the public system’s funding stream may increase public willingness to pay for rising health care costs

6. What are the challenges? Concerns with financial sustainability among SI programs that draw only on employment income Unless there is a single collection agent/risk pool, sophisticated risk adjustment mechanisms are needed to reduce incentives to select risks Regulation is vital to ensure universal coverage and standard benefits, and to integrate private (commercial) and not-for-profit insurers

7. Thank yousara.allin@utoronto.ca