here are several general areas of interest in understanding the overall level of support from both the Canadian public and major stakeholders for a single payer pharmaceutical plan in Canada. Gaining an understanding of these points would provide a foundation from which a hypothesis can be built, as well as a goal for research. The main topics include:
The relative importance of pharmacare
General agreement on the access to pharmacare
The role health benefits have on deciding on an employer
Opinion on different methods of distributing pharmacare
Opinion on different methods of funding pharmacare
The impact of limiting the range of employee health benefits on job markets
How employers would want national pharmacare to be implemented
Hypotheses that stem from these ideas can be categorized for both the general public and employers, who are key stakeholders. For the general public, the hypotheses are:
The general public would believe that pharmacare is not the biggest health care issue
The public would believe that giving more access to pharmacare is a positive idea
Losing potential health benefits from employers would be a negative factor for the public
The public would support providing pharmacare for at least those who do not have coverage as of now
Hypotheses about the opinion of employers are:
Employers would offer extra benefits through avenues besides health benefits
Employers would support national pharmacare as it would take off pressure from companies to provide the service to employees
The data that would be extrapolated would essentially be collected through surveys. The target population would be the general Canadian public and employers that do and do not provide health benefits (pharmaceuticals) for employees. To begin, the inclusion of a randomized general public will be discussed in order to convey the importance this target population would have on the political aspects of promoting national pharmacare. In contrast, a target population that is made up of frequent users of pharmaceuticals would not be appropriate. An example of a biased sample would be low socioeconomic status seniors dependent on prescription drugs. Though the majority of this population would rally emphatically for national pharmacare, seniors would not have as large of a political impact as the general public; thus, their support could only go so far in creating legislation. Having a varied population is essential to obtain a picture of the public perception of an issue. It is equally important to understand the opinions of the public in each province, as each will have different biases. Using quotas to understand these subgroups would be appropriate in this context. Finally, having an adequate sample size is important to get an accurate representation.
Next, employers are major stakeholders as they have political power both financially and through providing employment. A biased group of employers to avoid using would be a company that does not offer any health benefits. A company without health benefits would completely support national pharmacare: competitors who offer additional benefits would have one less advantage to offer to potential employees. It would be optimal to incorporate a randomly selected group of employers that offer and do not offer benefits to acquire a more accurate reflection of the context.
There are several methods of surveys that can be used such as email, web page, telephone, personal interviews, and mail. However, for the purpose of this study, which is to understand the informed general public’s perception of pharmacare, a mix of electronic systems and mail would work best. The survey could be accomplished through two different methods. The first method would be the administration of emails to residents, which would prompt individuals to fill out a survey on pharmacare on an external federal website. The external site would contain essential information (in the form of a short video) to help inform survey takers and would not take any longer than 5 minutes to complete. By being informative as well as efficient, the survey could be completed very quickly and results interpreted immediately. In addition, electronic surveys can be easily distributed so the population sample size would be larger than if, for example, mail surveys were given. Electronic surveys also practically have zero cost once designed and distributed on the internet. A second necessary method would be to send out the survey in the mail mail with a brief and informative brochure on the impacts of pharmacare. Despite being slower and potentially reaching fewer people than electronic surveys, traditional mail would be the best medium for those who have trouble accessing the internet. By having two methods of completion, the survey will be accessible to most groups, therefore providing an accurate description of the support from the general public.
The first limitation of an electronic survey is obtaining a list of email addresses. There must be a system in place where only Canadian residents can respond to the survey. A majority of residents may ignore the emails, thus, the specific group who does respond will represent the voice of general public. In addition, many populations, such as those of low socioeconomic status and seniors, may have troubles accessing an electronic survey. In the case of sending mail surveys, the main limitation is its efficiency; however, it may have a larger scope in demographics.
The anticipated results from the proposed hypotheses could resemble the results of previous studies:
The general public would believe that pharmacare is not the biggest health care issue
Canadian public does not see pharmacare as a primary health care issue as there are other serious topics. When asked an open ended question in a 2012 survey by Ekos Research Associates, the top three responses related to wait times, while medication was 4th at about 7 per cent.
The public would believe that giving more access to pharmacare is a positive idea
88% Canadians agree that access to pharmacare would be a good idea in a 2015 Angus Reid Institute.
Losing potential health benefits from employers would be a negative factor for the public
Canadians found that health benefits provided by employers were extremely valuable when deciding between jobs.
The public would support providing pharmacare for at least those who do not have coverage as of now
Approximately 50% of respondents in a 2015 Abacus Data survey believed that pharmacare should cover everyone who is not covered as of now.
Employers would offer extra benefits through avenues besides health benefits
85% of employers agreed in a 2012 Ipsos Reid survey that they would still offer additional benefits as it would attract new employees, as well as keep ing employees.
Employers would support national pharmacare as it would take off pressure from companies to provide the service to employees
Over 50% of employers in a 2015 Aon Hewitt survey agreed that a national pharmacare program should replace their current benefit offers.