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Category Archives: Homeless
Facts???? We’re the Government.
The response (below) to my call for the provincial government to stop bedevilling British Columbians struggling to survive serious health challenges (and the poverty that so often goes with it) has me pondering whether the government pays attention to what you say or, spotting a few key words – Air Miles®, PharmaCare – reply using a rote response or form letter.
Nowhere in the reply were the facts or points I raised addressed.
Of course the reply didn’t contain any facts or evidence to support the government’s assertion ‘the government was subsidizing the incentive programs’. Further, the government’s reasoning (more accurately what passes for reasoning in government and the bureaucracy) is based on multiple coulds.
Could. And based on the speculation of could, the government took a benefit from the seriously ill who practiced good fiscal management.
Although……basing policies on what government insists on believing, on the speculation of could, rather than facts, does explain the sad state of BC’s finances, healthcare, education, housing, deficit, debt, etc.
Those collecting points were maximizing the bang for the taxpayer buck. By collecting points they got the medications taxpayers paid for and through the collection of points they got $20 worth of food or gas to supplement their (inadequate) support (and if the politicians and bureaucrats feel it is adequate, I propose we set the salaries of MLA’s and bureaucrats at this ‘adequate’ level).
So, not only is the government’s incentive program policy not saving the taxpayers any money, it is wasting the cash value of the rewards that are no longer collected.
I also found myself wondering if, after the Bureaucratese of the reply had been slapped together, anyone had bother reading what had been written.
Take the lecture on the free market. While it might be suitable as an introduction to economics in middle school its simplistic view fails to capture the complexity of the free market as it functions in the real world.
Such as the difference in the economics of standalone pharmacies versus pharmacies contained within (or part of) a retail operation such as grocery stores or London Drugs; or the consequences of a pharmacy being part of a larger entity (Safeway) which has an incentive program that applies to the goods of the entire store.
So, we have government policy based on the speculation of could and economics and finances suitable to middle school but not for application in the real world.
Then we have this beauty:
” pharmacies set their drug prices and dispensing fees based on what they believe the market will bear – or more specifically on what they believe their customers will pay.”
“ While PharmaCare does not have the ability to “shop around” it does set maximum amounts for which government will pay.”
PharmaCare sets out what (the maximum) it will pay. Therefore the pharmacies have no need to base their prices on “what they believe their customers will pay.” If the pharmacies know what PharmaCare will pay, then by the governments own assertion that is what the pharmacies will charge for medication for those on PharmaCare.
According to the government reply, the amount PharmaCare would have been paying when British Columbians in need were allowed to collect Air Miles® (or other incentive programs) was the maximum amount PharmaCare had set for each specific medication being taken.
According to the government reply, the amount PharmaCare is paying now that government policy prevents the collection of Air Miles® etc is the maximum amount PharmaCare sets for each specific medication being taken.
So, according to the governments own rational it does not matter whether Air Miles® (or other incentive program points) are collected or not, knowing what the maximum amount PharmaCare will pay for any specific medication, means that (the maximum) is what pharmacies will charge.
By the governments own rational, changing the policy on incentive program points collection has not saved the taxpayers any money. Conversely the collection of incentive program points did not cost the taxpayers any money.
The effect of the change in policy is to fail to obtain the maximum bang for the taxpayer buck by not collecting the rewards that are available as a result of taxpayer dollars spent on medication.
And then::
“Rather than offering loyalty rewards, if a pharmacy sets its drug price or dispensing fee at a lower amount to attract customers, then customers, PharmaCare and all taxpayers will save money.”
Setting aside for the moment the fact that, according to the government’s own rational, the price charged to PharmaCare (loyalty rewards or no loyalty rewards) will be the maximum that PharmaCare has set out as the amount it will pay for a specific drug, consider the following points.
In the free market cutting prices to attract business leads to price wars. Incentive programs tend to be offered by large retail chains/organizations (such as Safeway Wal-Mart) who have the financial wherewithal to win such a war.
When was the last time (if ever) you heard or read advertizing for pharmacies that was based on the prices for prescription drugs?
Even if a pharmacy does charge a lower unadvertised price how are people going to find it? Do you check around to find the lowest price ever time you get a prescription?
If you are on PharmaCare it makes sense to make an effort to fill your prescription somewhere you earn rewards that are useful to you or your survival. If you cannot collect rewards, are you not going to choose a pharmacy based on convenience or cost savings realized by using that pharmacy?
Also affecting the decision as to which pharmacy to use – I always get my medication at the same place. They have my records and we have a year’s long relationship. As a safety measure I have no interest in going to a strange, unknown pharmacy. (I have had my pharmacy catch and correct what could have been a fatal error in medication prescribed).
Then there is the question of how people are suppose to check prices. Pharmacies do not quote prices over the phone – you have to go to the pharmacy. How reasonable is it to expect people living on extremely limited budgets to spend their gas budget driving from pharmacy to pharmacy to compare prices – particularly after you have taken away the $20 reward they used for gas at the end of the month? How reasonable is it to want people to compare prices when market forces dictate that all pharmacies will be charging the same amount – the amount set out by PharmaCare.
I do not have the information to properly analyze how PharmaCare sets the maximum price it will pay for each medication it covers. However I would assume that PharmaCare behaves at least semi-rationally (I know – a dangerous assumption when referring to government). Meaning that PharmaCare would set its maximum rate based on the wholesale cost (the cost to pharmacies) of the specific medications.
Unless PharmaCare is allowing for a ridiculously large mark-ups (if it allows any mark-up at all), then pharmacies make little or no money on the mark-up over cost on filling PharmaCare prescriptions. Thus if PharmaCare is behaving in a fiscally responsible manner in setting the maximum it will pay for a specific medication, a pharmacy will need to charge the maximum PharmaCare will pay.
Once again, incentive or no incentive program, the amount charged by a pharmacy is going to be the maximum amount PharmaCare has set out as what it will pay.
If the government has evidence to support its claim that the collection of points in incentive programs is costing taxpayers dollars they need to present that evidence.
Evidence based on facts, not the speculation of ‘could’ or fairy tales. Because, if the government of BC insists on making policy based on speculation and fairy tales, I want to know why the government hasn’t solved all its financial and service woes by having Rumpelstiltskin in the legislature basement spinning straw into gold?
The government needs to remember it is suppose to help, not persecute or hinder, the Wellness of citizens in need.
It should be maximizing the bang for the taxpayer buck, rather than wasting the rewards that accrue to the dollars taxpayers spend on medication by allowing the collection of reward/incentive points – points that cost the taxpayer not one additional cent.
Perhaps if the government ceased to waste time and resources chasing mirages of nonexistent savings or dreaming up ways or excuses to abuse British Columbians in need of help, the government COULD address major issues such as the rationing and cutbacks of healthcare.
Whether malice or maladroitness it is time the government ceased to tyrannize British Columbians suffering from serious health issues and a lack of personal resources by allowing them to collect Air Miles® (or participate in other incentive programs).
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Dear Mr. Breckenridge:
I am writing in response to your emails of July 11 and 18, 2011, regarding the restriction on incentive programs such as Air Miles®. I am pleased to respond on behalf of the Honourable Michael de Jong, QC, Minister of Health.
As you are aware, the British Columbia PharmaCare program is the publicly funded drug insurance program operated by the BC Ministry of Health. The purpose of the PharmaCare program is to assist British Columbians, particularly those with lower incomes, with the cost of eligible prescription drugs and designated medical supplies.
Community pharmacies in BC are retail enterprises that operate in a free market. A free market is defined as an economic system in which prices are determined by unrestricted competition between privately owned businesses. Like other retail businesses, pharmacies set their drug prices and dispensing fees based on what they believe the market will bear – or more specifically on what they believe their customers will pay.
There is a wide variation on what pharmacies in BC charge for prescription drugs. If people purchasing prescription drugs at the higher cost drug stores shopped around, they could save up to 25 percent on their annual drug bill.
For example, people taking commonly prescribed atorvastatin (generic Lipitor) 10 mg once daily could pay over $40 for a 30 day supply of the drug at the more expensive pharmacies in the province. The same amount of the same drug could cost less than $30 dollars at less expensive pharmacies. PharmaCare currently reimburses up to $31.56 for a 30 day supply.
Incentive programs encourage people to shop at a particular pharmacy or pharmacy chain by enticing them with such things as loyalty points, coupons, discounts, goods, rewards and similar schemes rather than with lower prices. Incentive programs cost retailers money, which they build into the price they charge consumers. Customers, particularly those where an insurer pays all or part of their drug costs, may become more concerned about the rewards they are receiving than the cost of the drug. Over time this can contribute to price escalation.
This new policy respects the right of pharmacies to offer incentive programs for customers, but takes government out of the business of subsidizing them.
PharmaCare is also a community pharmacy customer, spending as much as $1 billion annually on prescription drugs for its beneficiaries. While PharmaCare does not have the ability to “shop around” it does set maximum amounts for which government will pay.
While PharmaCare sets a maximum amount it will pay, not all pharmacies bill at the maximum amount. Rather than offering loyalty rewards, if a pharmacy sets its drug price or dispensing fee at a lower amount to attract customers, then customers, PharmaCare and all taxpayers will save money.
Please be aware that the restriction on inducements only affects the portion of a prescription paid by PharmaCare. You may still choose to get your prescription from a pharmacy that offers incentives so you can accrue points/rewards on the amount you pay out-of-pocket.
Further information on PharmaCare’s policy on inducements has been posted on the PharmaCare website. The Information can be viewed at:
http://www.health.gov.bc.ca/pharmacare/pdf/inducements.pdf.
I appreciate the opportunity to respond to your concerns, and trust that this explains the rationale for restricting incentive programs.
Sincerely,
Bob Nakagawa, B.Sc. (Pharm.), ACPR, FCSHP
Assistant Deputy
Canada’s Trade in Death
Concordat:
I hereby attest and aver that as a Canadian of honour, integrity and ethics it is depraved, and therefore categorically unacceptable, for Canada to be exporting death (slow, painful death) and industrial disease – in any form and for reasons as perverted as jobs, profits and electoral advantage. I demand that the federal government make this trading in death illegal – immediately.
I call upon all Canadians of integrity and ethics to join in condemning this depraved export of death and industrial disease and demand the federal government make this trading in death illegal – immediately.
I call upon all Provincial, Territorial and Municipal politicians and governments of integrity and ethics to pass motions condemning this depraved export of death and industrial disease and demand the federal government make this trading in death illegal – immediately.
I call upon all Members of Parliament of integrity and ethics to come together, regardless of political affiliation, and make it a priority to immediately introduce and adopt legislation making the export of death and industrial disease illegal – immediately.
In stating that he won’t allow cancer causing asbestos to be reintroduced in Canadian homes or schools but he’s firmly behind allowing Quebec’s asbestos industry to export the death and disease that its product causes to willing buyers abroad, hoping that it will enable the Tories to win a seat in the area; in ignoring the fact Conservative MP Chuck Strahl did not seek re-election because he has been diagnosed with incurable lung cancer – mesothelioma – believed to be triggered by breathing asbestos when he was younger; Mr Harper has demonstrated a level of ethical and spiritual corruption and turpitude such that he is unfit to be involved in any manner with the governing of Canada and such that his presence in Ottawa defiles Parliament, the Government of Canada and the Citizens of Canada.
Mr Harper and any members of his caucus, indeed any Members of Parliament, Provincial, Territorial or Municipal politicians supporting this trade in death on the grounds of profit, jobs and/or political advantage are unfit to be associated in any manner with the Government of Canada, any Province, Territory or Municipality and must resign.
Should Mr Harper refuse to resign, a high probability outcome given the level of depravity his statements, actions and non-actions on the prostitution of Canada by trading in death, it is the moral duty of the Conservative caucus to remove Mr Harper from the caucus and any association with the Conservative Party.
Should the Conservative caucus choose to join Mr Harper and descend to his level of ethical and spiritual corruption and turpitude, any members of the Conservative caucus with integrity and ethics must resign the caucus and serve Canadian citizens by sitting as independents and working with other Members of Parliament possessing integrity and ethics to stop Canada and Canadian business from exporting death.
All Members of Parliament with integrity and ethics must not only wrest control of Parliament from those so depraved as to see nothing wrong with trading in death and put an end to this trading in death, but must also do all within their power to end any connection between Parliament and any members of parliament with a level of ethical and spiritual corruption and turpitude as to refuse to ban the export of a cancer causing death material.
Failure to act on ending this trade in cancer death and disease by Parliament and Provincial, Territorial or Municipal governments demonstrates they are unfit to govern and any government or level of government that demonstrates its’ unfitness to govern should be treated as non-existent.
Unfit governments should be shunned until they demonstrate they are at least minimally fit to be a government.
Whatever government Canadians deserve or are, for the most part willing to accept, no Canadian of any integrity or ethics can accept a government or governments so depraved as to be willing to export asbestos materials that cause cancer and death.
The only course for Canadians of integrity and ethics is to call for the resignation of all those who support or refuse to end the Death Trade and to focus on civil disobedience until at least minimal ethical behaviour is restored to governments in Canada.
We can starve the monstrous beast by refusing to feed it what it must have to exist – citizens financial support.
Forcing the federal or other levels of government to cease to sully all Canadians with their corruption and turpitude will not be easy, but it can be done.
The question every Canadian must ask themselves is what value they place upon their own integrity, ethics, spirit and souls?
Perfectly Rational, Totally Irrational
Having been a Chartered Accountant the financial, planning, management and leadership skills and abilities, together with experience, gained over a quarter century on this career path have proven useful in a broad array of areas and ways.
It does however, come with a few drawbacks I never would have anticipated having to deal with.
My income is fixed, has been fixed at the same level for the last 5+ years; my living and working expenses are few, straight forward and over the years have been creeping or leaping upward – a reality all Canadians are having to deal with. Have you checked the prices of yachts lately?
As a matter of mental wellness I have avoided putting pen to paper to draw up a budget. This decision is not about being in denial after all:
Reality does not care what you want to be true, it does not care what you believe to be true. Reality simply is. Tao of James
It is a decision about dealing with the reality I live with – depression, anxiety, panic and a propensity as an adult child of alcoholism for self sabotage.
Unfortunately with the fixed nature of revenue (income), the few expenses left after years of paring away expenses (haircuts, clothing, food, etc) and the fixed nature of many of the remaining expenses (insurance, phone, internet) budgeting and cash flow statements/analysis are so simple I can do them in my head.
Or more accurately I cannot NOT do budgets and cash flows in my head and so the train wreck that is the financial reality of my future is a constant and unavoidable awareness in my head. The slippage for phone and internet bills already has me slipping a few days later in paying them every month, with the point in time when I reach the point the services are terminated because I am too far behind inexorably moving nearer and nearer.
I watch the numbers unwind as more expenses must be shed until the point where revenue is sufficient to pay only the rent and I become in effect a prisoner in my home, unable to go anywhere except by walking. Which as a result of physical limitations and the pain that results from these limitations, places a maximum distance on travel of 100 – 200 meters.
Of course without food or the ability to obtain food the ability to pay the rent (at least as long as it does not go up) is rather moot. You can live homeless, you do not survive long foodless.
The inability to NOT have this awareness of budget and cash flow and the approaching ‘economic collapse’ and its (without a significant change in personal financial reality) inevitability has demanded and occupied space in the continuous awareness area of my mind.
I seem, at least for now, unable to put this awareness aside and focus on getting on with life.
Instead I find myself wanting to get out from under the stress, wishing that my ‘stuff’ was in storage and I could ‘solve’ the approaching time when economic reality exerts its negative consequences on my life by moving out from under the looming crash and into my car.
Circumstances had me living in my car before so there is no fear of the unknown, I know what needs to be done to survive living in your car. Indeed services added since I was last living in my car make living in your car simpler and more doable today.
In a way living in your car simplifies your life because you have to focus on doing what you need to in order to survive.
At some point either a rent increase or the need for food will force me out of my home and either into my car or onto the street.
There is a great deal to be said for choosing when, rather than waiting until there is no choice (based on the experience of having reached that no choice point).
Ironically a move to the car improves cash flow as one loses the $375 rent portion of revenue but gains the cash difference between the $375 and actual rent paid.
One of the real advantages for me of having a fixed address is internet access, an access that will in the near future be lost as it is the next item on the chopping block of financial expenditure reductions necessity. Which means internet access must be obtained at the library and the major incentive for struggling to preserve having a ‘home’ ceases to exist.
When the only use made of home becomes as the place one sleeps, is the money spent on gas to drive ‘home’ and the money spend on a ‘home’ that could be available for keeping the car in shape and running or to meet emergencies, a wise use of extremely limited financial resources?
Consider as well that I have no land line phone service. My only phone is a cell phone which is not only mobile (a service seeming designed for those with non fixed address) but provides email and messaging.
There are other points one can cite in support of choosing to join the growing community of people in Abbotsford whose automobile has become, among its other attributes, their home arguably a perfectly rational choice.
Yet friends, mental health professionals and others maintain that even thinking about abandoning my home, moving into and living in my car is totally irrational thinking.
Which is what I would be telling someone else if they were thinking of surrendering and moving into their car. That they needed to keep working and plugging away at things and see what develops or happens to change their financial circumstances (employment etc).
But watching the numbers and the future unroll in my mind makes the struggle with depression, anxiety and the urge to panic an ongoing, daily battle complicated by an ongoing struggle not to give into an act of self sabotage.
Living with mental illness and the quest for mental wellness is enough of a challenge on its own.
I really don’t need the additional headaches and stress that come with constant awareness of the budget and cash flow realities and the inevitable negative consequences of this financial future.
At times the urge to panic, to escape is overwhelming – no matter how irrational those actions would be.
I really wish……but then……
Reality does not care what you want to be true, it does not care what you believe to be true. Reality simply is. Tao of James
Some days, to many days, running down the middle of the road trying to pull my hair out and screaming Arrrggggghhhhhh seems so appealing – and so rationally irrational.
NOT a homeless woman’s shelter.
People were telling me about reading of a new homeless woman’s shelter that was going to open in Abbotsford.
Since I was unaware of plans for a homeless woman’s shelter/housing, I searched out a paper to read the article people were referring to. And there was the headline: ” New housing project for homeless women.”
Compounding the headline’s ability to create the wrong impression, the article did not clearly set out the purpose of the housing project on Clearbrook Road was and why the project was important for the wellness of the project’s residents and in addressing homelessness in Abbotsford.
This is not a shelter it is an apartment building. Homeless, mentally ill, addicted women will not be snatched off the street to live in the project. As Ms Willis stated: “This is an alcohol- and drug-free facility, and there will be no high-risk clients.”
It is second stage housing for Abbotsford, similar to the 13 units of second-stage housing the Women’s Resource Society of the Fraser Valley operates in Mission at Taulbut House. It will provide affordable housing so the women do not become homeless or have to live in danger of becoming homeless.
I can attest to how attention diverting, stressful and wearing it is when you are never sure you will have a place to live next month – until the moment when you have managed to pay the rent at the beginning of the next month. At which point the cycle of worrying whether you will have housing the following month begins to gnaw at you mind again.
The security, the stability, that affordable housing provides is invaluable in being able to focus on getting your life back on track, is a vital support to the woman (and their children) in getting their lives back on track.
” Executive director Pamela Willis said the Clearbrook Road project will allow the society to offer a a new level of support to women. “
Support is, in its way, even more important than affordable housing in getting your life back on track, in getting through the rough spots and over barriers.
I say this because it was support from friends that allowed me to overcome problems and not end up homelss in 2010. Friends were also the reason I made it through 2010 and the challenge posed by the rationing of mental health services.
Recovery and finding wellness is not a short, simple or easy process. Which is why the housing and support provided by the Clearbrook Road project is so needed.
There are emergency shelter spaces for woman who are homeless. There are first stage/minimal barrier spaces – although not nearly enough. There are treatment and recovery house spaces for woman.
What there hasn’t been – and what this project will provide – is safe, healthy, supportive, affordable housing to allow women to continue their journey of recovery, to help them get their lives back on track and to help them (and their children) find wellness and joy.