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A visitor arrives at the Roberta Place Long Term Care home in Barrie, Ont., on Jan. 18, 2021.

Frank Gunn/The Canadian Press

Early in her budget speech, Finance Minister Chrystia Freeland offered a heartfelt apology to the hardest-hit victims of the COVID-19 pandemic, Canada’s elders.

“To them, and to their families, let me say this: I am so sorry. We owe you so much better than this. As a country, we must fix what is so clearly and utterly broken,” she said, unveiling budgetary measures she described as “partial repayment.”

“Partial” is the operative term here, if we’re being generous.

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Of the more than 23,500 COVID-19 deaths in Canada, almost 17,000 have been in congregate care settings such as long-term care facilities and retirement homes.

The breadth and depth of this carnage should have sparked a fundamental rethink of how we care for elders in this country. Instead, we have more of the same: earnest words and little real action.

In the budget, Ottawa committed $3-billion over five years, starting in 2022-23, “to support provinces and territories in ensuring standards for long-term care are applied and permanent changes are made.”

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No commitment to what an actual minimum standard should be, such as four hours of hands-on care daily for each LTC resident.

No money for better infrastructure. No investment in home care – so elders have an alternative to long-term care. Nothing for caregivers either.

A child-care program – the bim, bam, boom announcement in the budget – is a great health initiative. It will make for healthier children and provide an economic boost by allowing more women to work.

But we can’t forget that as many women (and, let’s face it, it’s overwhelmingly women) care for aging parents and in-laws as they do for children.

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In our aging society, support for caregivers of elders – with adult daycare respite care, flexible employment rules and more – should matter, too.

When you commit $30-billion over five years to ensuring Canadians have affordable child care and zero to ensure they have affordable elder care, something is out of whack.

Ottawa has spent big on the pandemic, including about $8-billion on COVID-19 vaccines. So it’s puzzling that it would not invest in some essential long-term fixes, such as creating a national vaccine registry.

Similarly, while there has been a lot of chatter about how Canada’s lack of domestic vaccine production hampered the pandemic fight, there are no big new initiatives.

The budget included $2.2-billion over seven years “toward growing a vibrant domestic life sciences sector.” However, the money is being distributed through a series of scattergun (or is that scatterbrained?) investments in various agencies – the Canadian Foundation for Innovation, the Vaccine and Infectious Disease Organization, the Stem Cell Network – and little additional support for the trio of granting agencies that are supposed to oversee health research in the country. There’s a good chunk of money for mental health, almost $1-billion over three years, most targeted for high-risk groups such as Indigenous communities, front-line workers, veterans with PTSD and racialized communities.

A big loser in the fiscal blueprint is pharmacare. The word is barely mentioned in the 739 pages of budget documents, a vague promise to “continue to engage with willing partners on national universal pharmacare, alongside other important health priorities.”

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The overdose epidemic, which has claimed as many lives as COVID-19 in some provinces, also barely merited a passing mention, with $116-million in additional funding.

While it’s a predictable response regardless of what’s in a federal budget, the premiers will no doubt be disappointed with what they’ve been offered to support struggling health systems.

Late last year, Ottawa provided a one-time boost of $4-billion in health transfers to the provinces but the budget does not provide any additional funding, other than $54-million to the territories.

The premiers, in a rare united voice, have been pushing hard for a big boost in the Canada Health Transfer to $70-billion annually from the current $43.1-billion (which grows by 3 per cent annually).

The federal government made a strategic decision that it will get more political bang for the political and economic buck by investing in child care than spending more on the seemingly bottomless pit of sickness care.

That’s probably a good short-term bet.

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But, eventually, the backlog of neglected care over the past year, and the swelling desire for better elder care in the future, is going to catch up with governments, and that debt will have to be paid – in full.

When the COVID-19 fight ends, a bigger health challenge will begin.

The 2021 federal budget will continue economic support for businesses and individuals through the summer with a roadmap to wind them down later in the year as more Canadians are vaccinated against COVID-19.

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters and editors.

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