Not So Universal: The Reality of Universal Healthcare for Canadians with Diabetes

Not So Universal: The Reality of Universal Healthcare for Canadians with Diabetes

My Diagnosis and Early Life

I was diagnosed with type 1 diabetes (T1D) when I was two years old. After five days in the hospital on an insulin IV drip, I transitioned to insulin injections for about a year before switching to an insulin pump shortly before my fourth birthday. I was lucky to have access to the best technology and parents who were able to take care of all my needs. My mom took years off of work to manage my diabetes, while also taking care of my newborn baby brother.

Photos: Zainab and her family

Looking back, I realize how fortunate I was. I never had to think about whether I’d have a support system at home or if I could afford the technology I needed to stay alive. But as I’ve grown older and I’ve had the opportunity to connect with others living with T1D (like through DHF), I’ve come to understand that, unfortunately, not everyone shares this privilege. Many people didn’t have the opportunity to have their parents take time off of work and still be able to afford an insulin pump.

The Reality of Universal Healthcare in Canada

Canada is often celebrated and praised for having a universal healthcare system, but for those with chronic illnesses like T1D, the reality of treatment is more complicated. We are the only country in the world that has universal healthcare, but not universal pharmacare. This gap means individuals with chronic illnesses like diabetes often have to cover the costs of essential medications and technologies out of pocket or with private coverage plans. Diabetes supplies can cost up to $18,000 a year, depending on the technology needed. That’s a steep cost that people with T1D have to constantly think about and pay for the rest of their lives, just so they can live.

The Emotional and Financial Burden

The stress and the emotional burden of that cost is equally heavy. It’s known that without technologies like insulin pumps or continuous glucose monitors (CGMs), blood sugar management becomes much harder. This increases the risk of serious physical health complications down the line, like kidney disease, neuropathy, and heart attacks. But it also increases the risk of anxiety, depression, and declining mental health as well.

Progress and Hope

Despite these challenges, things are improving. Programs like the Assistive Devices Program (ADP) in Ontario help subsidize insulin pumps, making them more accessible for those in need. I’ve benefited from ADP since I was four years old, and I’m grateful for its support in paying for life-saving technology. On a larger scale, Bill C-64 – An Act Respecting Pharmacare was passed in February 2024. This bill marks a step towards universal pharmacare, which could significantly ease the financial burden on individuals with chronic illnesses. While there’s still a long way to go, these initiatives show that progress is possible.

Investigating Healthcare Inequalities

Earlier this year, I set out to investigate these inequalities in diabetes healthcare. My research led me to record Not-So Universal, a short mini-series podcast that delved deep into this topic. As I listened to personal stories and conducted interviews with those impacted by these disparities, I discovered how listening to their voices can help us uncover these pressing issues with our system. They can show us how unequal access to life-saving technology creates a divide in quality of life and health outcomes in Canada that affect their daily lives.

This is a short, mini-series podcast where we’ll be exploring the inequalities in diabetes healthcare that creates a divide in quality of life and health outcomes in Canada. Whether you know someone with diabetes, are looking to become a more informed citizen, or are a policymaker, this podcast is for anyone interested in learning about the socioeconomic disparities in diabetes technology access, and exploring what we can do to support a more inclusive healthcare system that serves all Canadians. Download the “Not So Universal” Podcast Transcript >

Advocating for a More Inclusive Healthcare System

Whether you know someone with type 1 diabetes, want to become a more informed citizen, work in the healthcare industry, or are a policymaker, Not-So Universal is for anyone interested in understanding the socioeconomic barriers to diabetes technology access, their far-reaching impacts, and the systemic factors like legislation that impact health outcomes. Join me, and together we can work towards a better, more inclusive healthcare system that serves all Canadians.

Further Reading:

• Moving Forward on Pharmacare for Canadians – Canada.ca
• Dexcom CGM Coverage with Alberta Health | Dexcom
• https://www.dexcom.com/en-ca/faqs/british-columbia
• Government of Canada signs pharmacare agreement with Manitoba to improve affordable access to medications – Feb 27, 2025
• British Columbia, signs on to the National Pharmacare program. We will continue to monitor to better understand the impact of this deal on Canadians living with T1D, as details on the insulin and device coverage, which is set to begin March 2026, are still unknown. View news release >
• Prince Edward Island signs on to the National Pharmacare program, set to begin May 1st 2025. View news release >

Sources:

1. Zainab’s mother, as quoted in Episode 1 of the Not So Universal podcast, hosted by Zainab Z, 2025.