CURB EXPECTATIONS

Federal Health Minister Tony Clement told a meeting of Canada's
doctors Monday that the status quo of medicare was not sustainable,
and that he is open to innovation, including use of private operators
to deliver health services. He had little more to say on the topic,
however, suggesting that this is not Mr. Clement's priority. He spent
more time extolling the virtues of his government's plan to launch a
war on drug use in Canada.

Mr. Clement's speech to the Canadian Medical Association meeting in
Vancouver paid just enough lip service to private and public heath
care that both sides on the medicare debate could feel optimistic.
The status quo is not sustainable, he said, giving cheer to those who
would push greater use of private operators. Advocates of a single,
universal health system found refuge in his assurances that the
Conservative government will not mess with the Canada Health Act. It
was a classic speech of a polished politician intent on avoiding
controversy. Under this minority government, Canadians may see
minimal change in a system suffering from chronic, lengthy wait times
and expensive inefficiencies.

Mr. Clement's speech indicated he will focus on the easy stuff -- the
agenda includes warning kids away from drug use and reviewing the
Hazardous Products Act for better protections against foreign (read
Chinese) products that can threaten people's health.

There is nothing wrong with an anti-drug campaign; parents will
welcome the public support of their lectures to adolescents. For drug
addicts, Mr. Clement's speech gave worrisome signs a crackdown on
drug use may see the closing of Canada's only safe injection site, in
Vancouver, which relies on an exemption to federal drug laws. Despite
evidence that addicts are living longer and getting health care they
need at the site, Mr. Clement told the CMA that to him, "harm
reduction" means prevention, treatment and enforcement.

A minister in a minority government is unlikely to step into the
minefield of medicare reform. In health care, progress only rarely
comes in the form of radical change. But Mr. Clement should be wary
of undoing the small measure of hope held out to addicts as he
declares war on drug use in Canada. He needs to acknowledge the fact
that some addicts will never go clean, but still deserve the best
that public health can offer.