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For a Throne Speech that purports to make Canada more consumer-friendly, there is a glaring omission. That is, attention to the things that matters most to consumers – their health and the future of their health system.
Sure, there is a bevy of minor health-related initiatives – most of them regurgitations of earlier announcements – but the government has glaringly avoided tackling the most pressing issues in health care.
Take, for example, the promise to ensure that drug labels are written in plain language. That's nice, but it's window dressing.
Easy-to-read labels are not especially helpful to those who can't afford drugs in the first place, and that's a growing constituency.
The prescription drug issue that really needs addressing is pharmacare – finding a way to make necessary prescription drugs affordable to all Canadians, regardless of income, age and where they live.
Currently, Canada's drug 'system' is not a system at all; it's a patchwork of private and public plans with holes in it that offend and undermine the principle of medicare.
Many people get drug coverage via their employers, many of whom are cutting back because of soaring costs. In most provinces, seniors and those on social assistance have prescription drug coverage but it is being watered down with a host of new co-payments and other restrictions.
Then there is the issue of orphan drugs – medications that can help a small number of individuals with rare conditions, but at enormous price, sometimes as high as $300,000 a year.
Ottawa could play a crucial role in resolving these two crucial issues and bolstering medicare and do so without meddling in provincial jurisdictions. It is telling that word "medicare" does not appear in the 7,000-word Throne Speech.
Instead of taking a leadership role in health care, the government of Stephen Harper has opted for bromides, like saying Ottawa will be encouraging young Canadians to be more physically active and work to reduce injuries in children, without providing any detail.
Worse yet, on a couple of issues, the government has opted for pettiness and vindictiveness over science and compassion.
The Throne Speech treats addiction as a criminal act rather than a disease. It even features the jaw-dropping line: "Our Government will…close loopholes that allow for feeding of addiction under the guise of treatment." That is an oblique reference to the practice of prescribing heroin to some otherwise untreatable addicts but suggests that well-established measures like methadone therapy and distribution of crack kits are in for grief.
One of the most interesting lines in the Throne Speech pertains to seniors: "The evolving and growing needs of Canada's aging population require that the federal government work with provinces and territories to develop a comprehensive, pan-Canadian seniors-care strategy, an important step toward meeting those needs."
It's intriguing because it says Ottawa is willing to work with the provinces and territories – something that is not all that obvious in their day-to-day interactions – but, again, where's the beef?
Creating strategies is all the rage but, too often, it's a substitute for actual action, or a delaying tactic. In this case, many jurisdictions already have a seniors' strategy. In Ontario, for example, Dr. Samir Sinha produced a masterful plan, entitled "Living Longer, Living Well."
Federal officials – elected and otherwise – would do well to sit down and read this document and figure out how they can: a) implement the recommendations for the groups to which they are responsible for providing care (aboriginal peoples, the Canadian Armed Forces and veterans, the RCMP); and b) figure out how they can help the provinces and territories implement change.
Seniors don't need more talk, they need actual action on their pressing concerns: better primary care, timely access to homecare and nursing homes, and end-of-life choices, to name only three biggies.
Speaking of end-of-life, the Throne Speech is completely mute on the single most burning debate in health care, physician-assisted death.
The unspoken message here is that the Conservatives plan to leave it to the courts to resolve. That's not leadership, and it's certainly not "consumer-friendly." It's a cop-out.
Silence and stalling are also the tactics the government has adopted on renewal of the Health Accord, which expires in 2014.
Two years ago, the Finance Minister announced that the Canada Health Transfer would increase by 6 per cent annually until 2017 and by roughly 3 per cent annually afterwards. The monetary amounts are fairly generous but the accord leaves Ottawa with no national health responsibilities or commitments other than cheque-writing.
That's a fundamental policy shift without any public debate. Not to mention that an accord should be the result of a negotiation between two or more parties, not a take-it-or-leave-it offer.
But maybe the Harper government is simply lying low on health care, waiting for the 2015 election campaign to announce some consumer-oriented health-care measures with bite and breadth.
But, with so many pressing needs now, especially for vulnerable groups like seniors, no government would be that cynical, would it?
André Picard is The Globe's health columnist.