While the same elements are present in Europe as anywhere else (rec vs. medical, federal vs. regional reform), they are in a different form and focus than is happening in say the U.S. or Canada or Israel.
The most crucial point of this debate, however, right now, is how cannabis is or will be covered by health insurance. Now and into the future. In Europe right now, that has also created a strange standoff across a normally peaceful, open border.
In the U.S., by way of comparison, there is a common problem that is traced to a lack of federal rescheduling. State-by-state reform in fact, has begun to look fairly standard. Some states are more liberal than others. California will begin to change a lot of precepts, but banking and insurance are off the table for the most part until reform happens at the federal level.
In Israel, a state-sponsored health insurance system plus other considerations (including whether cannabis is kosher and for whom and when) still creates a forward-focussed market that leads in research to this day. However this is a different animal than is what is going on elsewhere. Even though the Israeli system is clearly going mainstream medical.
Canada appears to be headed down a ‘recreational first’ path. And so far, insurers are not stepping up to the plate to cover cannabis. Right now it appears to be a loose discussion. And further, it could also be that insurers are watching what happens in Europe first, before making any broader commitments.
It does appear that the EU is actually the place where insurance coverage is going to be defined, outside of Israel, for the first time. Starting with Holland and Germany, the first countries to look at the same within the context of regional regulations and changing times. This is both where it gets difficult and intriguing at the same time.
In Europe, the discussion about whether to cover cannabis under medical coverage is centered in the Schengen states right now. That is a group of states in central Europe that have open borders, and special treaty rights separate from the EU, while being a part of it. In an American context, think say New England, with extra glue. And no federal Justice Department.
Holland, which has been the center of all things cannabis for several generations, also had recognized it as having medical efficacy. One firm, Bedrocan, was in fact, set up as a monopoly supplier both in-country and externally. And up until Q1 this year, Dutch insurers covered medical cannabis. But no more…
Literally at the same time Germany changed its own law to create both a domestic cannabis market and require insurers to cover the drug, the Dutch insurers dropped their own coverage. The reasoning? They do not see the medical efficacy of the drug, they say.
This is also likely to continue to happen across Europe. And it is yet another sign of how schizophrenic the debate still is.
In the short term, it has meant that the only Dutch medical supplier has had to look elsewhere, to other medical markets. In fact Bedrocan is now one of the finalists for the German medical domestic bid.
But what does this mean for the longer term? Why is it that the issue of “medical efficacy” has not been solved, yet, to the satisfaction of at least Dutch insurers?
There are a few things to remember. The first is that most scientific, investigative research about cannabis is still coming out of Israel. Everyone else is playing catch up. Germany, with a strong public insurance system that covers 90% of its population is now the place where medical efficacy will be proven. And further, where guidelines will begin to shape a global insurance industry that is coming to terms with a new medical kid on the block. In the meantime, expect a bumpy ride.
Expect all the same issues to be present here as they have been in other places. That starts with access, but does not end with it. It includes the acceptance of whole plant medication. It includes the debate about smoking flowers, vaping and edible consumption as well as vaping versus smoking.
At the moment widespread trials are not underway, but they undoubtedly will be. And sadly, until there is Euro-wide reform, insurers will likely play catch up, until forced to do otherwise on a systematic basis.[Image credit- Pixabay]
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