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Globe editorial

Globe editorial: What happened to that catastrophic drug plan?

From Tuesday's Globe and Mail

While governments fiddle, cancer patients in Atlantic Canada are unable to afford simple medications to control their nausea and pain. The stories of financial hardship and anguish told in these pages yesterday by The Globe's Lisa Priest are a scandal. After all the promises of a catastrophic drug plan, why in heaven's name has no plan materialized?

The answer, sad if unsurprising, is that the promises of a prime minister (two, actually: Jean Chrétien and Paul Martin) and the premiers were empty. Mr. Martin promised a "fix for a generation," but "wait for a generation" seems closer to the truth.

Why is a catastrophic drug plan so important? Because without it, medicare is not living up to its basic promise of equal access to decent health care for all. Rhonda Morey of South Brook, Nfld., is 33, has two small children and is dying of ovarian cancer. That should be worry enough for anyone. But she cannot afford the three nausea pills a day, at $30 a pill, that she is supposed to be taking. At times she has rationed the pills; once she wrote to a drug company, which sent her a three-month supply; and ultimately a former town clerk of South Brook went door to door in Ms. Morey's community of 580 people to raise money. That this should be necessary is truly heartbreaking in the Canada of 2006.

Nor is her case extreme. Another of the 600,000 people in Atlantic Canada who have no drug coverage is Robert Gill, 41, of Botwood, Nfld. He has cancer of the blood and bone marrow, lives on an $820-a-month disability cheque and has a $1,000-a-month drug bill. His income, small as it is, is a little high for the provincial drug card. There is a man whose governments have failed him.

Little in Canadian politics is more cynicism-inducing than finding out what became of health-care promises. The 18-month royal commission on health care led by Roy Romanow recommended four years ago that, beginning in 2004, Ottawa should reimburse the provinces for 50 per cent of drug costs over $1,500 per patient. Mr. Chrétien then signed a deal with the premiers in 2003 in which Ottawa gave $16.5-billion over five years to three areas: primary care, home care and catastrophic drug care. The provinces could allot that money as they wished in those three areas, and were supposed to report annually to their residents on how they spent that money. Only two ever reported: British Columbia and Saskatchewan.

Then, in Mr. Martin's $41-billion, 10-year plan of 2004, which the provinces signed on to, Ottawa folded the payments for primary, home and catastrophic drug care into one big payment, the Canada Health Transfer. The reporting requirement disappeared. "So it's even less easy to track now because it's all buried in one big transfer," Cathy Fooks said yesterday. She's the executive director of the Health Council of Canada, which Mr. Chrétien created to track all that spending.

So now Ms. Morey, Mr. Gill and those in similar situations in Atlantic Canada have to content themselves with the bureaucratic reports of the National Pharmaceutical Strategy, a federal-provincial group. Its June "progress report" offered no plan, no options costed out, no timeline. Where is the progress?

Nowhere on the horizon. The provinces want yet more federal money, and the feds have other priorities: waiting times, a cancer strategy, mental health. "We're still waiting to understand what a catastrophic plan will look like for the country, how it will be funded and when it will be put into place," Ms. Fooks said. "We don't have any idea when that will happen."

Most provinces have some form of catastrophic drug coverage. Only in Atlantic Canada do patients routinely choose to die in hospital rather than at home because they can't afford the medications. The first ministers should be obliged to travel to South Brook and look Ms. Morey and her children in the eye as they explain what happened to the promised catastrophic drug plan.

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