Taxing Disability: A Critical Look into the Medical Cannabis Regime under the New Cannabis Act, 2018

Medical marijuana users represent many people with disabilities in Canada. Recent legislative attempts have allowed people with disabilities to access cannabis as medicine, however the landscape is ever changing. The Cannabis Act was recently introduced, legalizing marijuana for all; however, people with disabilities have not been accounted for when it comes to the issue of access to medicine. Those who rely on cannabis as medicine and those who enjoy it recreationally are now part of the same system, for better or worse. The new medical marijuana regime, under the new Cannabis Act, boasts a “two-stream” process, and it claims that it will be maintaining and improving the old medical regime alongside the new recreational regime. The applicable taxes tell a different story. Medical marijuana has always been subject to sales tax despite being effectively prescribed by doctors to manage and treat many disabilities and illnesses. Now, with the enactment of the Cannabis Act, medical marijuana is subject to an excise tax too—colloquially known as the “sin tax.” Recreational and medical marijuana are subject to the same taxation scheme, making any notion of a “two-stream” process nonsensical and blatantly unfair. The purpose of this article is to provide insight into the varying faults concerning the medical marijuana regime in Canada, with specific emphasis on the issue of taxation. In the simplest terms, taxing medical marijuana is taxing medicine and effectively taxing people with disabilities. Broken down into five parts, this article discusses the underlying reasons for the taxes surrounding medical marijuana, provides a case study of the most important tax case for medical marijuana users, scrutinizes the lack of recognition of medical marijuana as a proper prescription, outlines the ways to improve legislation, and, finally, explores a potential Charter challenge that can be effectively brought against this taxation.

Does a training programme improve the perceived confidence and performance of student mentors in their delivery of a widening access to medicine programme?

Background – Brighton and Sussex Medical School (BSMS) uses medical students to deliver widening access to medicine (WAM) interventions. Previously, new BSMS teaching-mentors received no formal training beyond safeguarding procedures. A training programme for new teaching-mentors was designed, aiming to improve their confidence and self-perceived performance. This study explored its effectiveness. Methodology – Participants self-selected into an intervention group (received formal training) or a control group. The intervention group completed one questionnaire either side of receiving training; the control group completed one questionnaire after taking part in two WAM sessions. Four participants were selected for qualitative interviews which were thematically analysed. Ethical approval was received from the BSMS Research Governance and Ethics Committee. Results – Average confidence and average self-perceived performance within the intervention group improved significantly following training. There was no significant difference between intervention and control groups. Qualitative results uncovered three main themes: Need Training, Benefits of Training, and the Shadowing Day. Discussion – It is argued that whilst training is not essential, and should not be compulsory (if mentors are already confident, it does not augment their self-perceived confidence and performance), nervous teaching-mentors do benefit from a training programme, so it should be offered to new mentors, nonetheless.

Medical student mentors in widening access to medicine programmes: 'we're lighting fires, not filling buckets '

Background: Widening Access to Medicine (WAM) supports nontraditional applicants throughout application to study medicine and beyond. Many WAM programmes use medical student mentors, however, there is a paucity of research into what makes a good WAM mentor and what qualities they require. This research helps fill a gap in the literature about WAM scheme mentors and provides context for recruitment/training.<br/> Methodology: Purposive sampling was used to select three year 9 mentees, four year 9 mentors, four year 12 mentees and four year 12 mentors. No limitations were placed on gender or ethnicity. Thirty-minute semi-structured interviews were recorded, transcribed and analysed qualitatively, drawing on an interpretative phenomenological analysis approach. This study received ethical approval from the Brighton and Sussex Medical School (BSMS) Research Governance and Ethics Committee.<br/> Results: Four main themes were identified: mentor – mentee relationship, mentor background and attitudes towards WAM, qualities and behaviours of mentors and differences between year 9 and year 12 mentors.<br/> Discussion and conclusions: The results are discussed within the context of the existing literature. This research identifies the requirements for WAM mentors from both mentors and mentees' perspectives. This will inform future WAM schemes run at BSMS and may provide a basis for future research and improvement of WAM mentors nationwide.

National Health Insurance Scheme: A pathway to a sustained access to medicine in Nigeria

ObjectiveThe National Health Insurance Scheme (NHIS) has at its aim the need to ensure that every Nigerian has equal access to good quality health care services. So far, only the Formal Sector Social Health Insurance Program (FSSHIP) aspect of the scheme has been fully activated. The question remains, why the delay towards universal coverage?DesignThe study was a cross-sectional and mixed method design. Both qualitative and quantitative methods were utilized for the study.SettingThis study was conducted in NHIS accredited facilities in Enugu State.ParticipantsA sample of 300 enrolees were selected randomly. For the qualitative study, 6 in-depth interviews (IDIs) were conducted face to face with NHIS desk officers across the three tiers of health care represented.ResultsThe qualitative findings shows that 94.9% of respondents sought medical help. 78.4% of the respondents indicated that the scheme improved their access to care. The qualitative finding found that there was no discrepancy in access among socio-economic groups. NHIS was reported to have improved access to medicine over the years. In the qualitative, majority of the IDI respondents stated that many of the staff in NHIS accredited facilities are not trained on what is expected or required of them with regards to the scheme.ConclusionA focus on accessibility, affordability and availability for the scheme means that on account of either of the three, all facility categories and their interests must be considered in further planning of the scheme to ensure that things hold up fine.Article SummaryStrengths and LimitationsThe study participants were only from one state.The study only focused on NHIS and NHIS accredited facilities.NHIS desk officers, hospital directors and admin officers were the focus for IDIs.