Tuesday, January 31, 2006

What Would Ralph Say?

Interesting article outlines the discrepancies between the provinces when it comes to cancer drug access:

The study, which looked at more than 20 individual drugs that have become available over the past few years, found there is a marked difference in access to drugs from province to province.

"What is available to one patient in one province is not available to another patient with the same cancer in another province," Khoo said of the drugs.

"Never mind if they are provided for free or patients have to pay for them."

In its annual report card on the state of cancer care, the CACC warns that the current state of drug treatment does not honor the five guiding principles of the Canada Health Act.

Not only are these new drugs not universal in their coverage, the advocacy organization says, they are not publicly administered or funded, nor portable outside the provinces of residence, nor reasonably accessible, nor comprehensive in their integration with other treatments.

Here we have a perfect example of why national standards are required, despite "encroachment" on provincial jurisdictions. The issue of cancer drug availability also speaks to the possible consequences of two tier health care. People in Ontario, that don't have access to certain cancer drugs will be forced to provinces like B.C, that have better drug options. The uneven access means that Canadians don't have universal health care, but rather coverage is a function of location.

The recommendations of the Cancer Advocacy Coalition of Canada:

1) Establishment of a nationwide catastrophic drug strategy to resolve access deficiencies

2) Development and implementation of Canada-wide guidelines to speed up access

3) Increased research to identify subsets of patients who would best benefit from new therapies

4) Introduction of an ongoing evaluation process for new cancer drugs

5) Incorporate patient involvement and choice into decision-making

What would Ralph say? More national strategies and guidelines would surely be greeted with complete disregard. The provinces, as well as the feds, should approach health care with complete pragmatism. On the cancer drug issue, clearly it would be beneficial to have continuity and a framework that prevents uneven access. The provinces need to recognize that issues like these demonstrate the need for a national approach. Instead of constant turf wars that are predicated on ego, we need a spirit of mutual self-interest. Of course this notion works both ways, wherein if a province has devised an effective plan(i.e Alberta's ailment specific clinics that amount to "one stop health care"), Ottawa shouldn't interfere, but possibly "promote" to other jurisdictions. Row together, in a common direction, for the benefit of all.

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