A role for respiratory therapists in shaping Canada’s changing health policy landscape

S everal important changes to the way health care is delivered and funded are either underway or planned in Canada: all 13 Canadian provinces and territories, and the federal government have collaborated through the pan-Canadian Pharmaceutical Alliance (pCPA) to lower the price of commonly used medicines; Canada's federal Health Minister has signalled that a new health accord with the provinces will be negotiated to provide federal funding to provincial health services; several provinces have either indicated that they will move forward with public reimbursement schemes of pharmaceuticals , or have already implemented some form of this type of coverage; and Ontario has committed to a renewed strategy to strengthen and improve community based care. Many other examples exist, but the fundamental point is that the landscape of health care delivery and funding is changing. Each of these changes is occurring amid global concerns of the affordability of new health technologies , how best to care for an aging population and the poorly recognized but massive burden of noncommunicable diseases in low-and middle-income countries. The United States is currently embroiled in a contentious debate about the unaffordability of health care, generally , and of pharmaceuticals, specifically. There are growing demands for a renewed approach to biomedical research and development funding ; meanwhile, emerging global health threats push resources to the limits. Each of these can and do impact respiratory care, and respiratory therapists should take note. A common thread linking each of these issues is a call for evidence based health systems planning and policy development. The calls for evidence-based decision making extend beyond measures of clinical effectiveness of interventions, and includes the need for evidence of programmatic effectiveness and efficiency. It is insufficient to assume that old ways of doing things will be simply be upheld regardless of whether there is evidence to support it. There is a need for respiratory therapists to play a role in shaping this new dimension of health policy and planning for respiratory disease management, and our seat at the decision-making table needs to be urgently filled. Discussions of health system reform and innovative health policy approaches are not extraneous to the profession nor practice of respiratory therapy. Respiratory medicines are among the most commonly prescribed medicines in Canada, and respiratory diseases account for substantial morbidity and mortality. Respiratory therapists are intimately involved in helping patients with all of these, and we should be working …