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A Strategy for Home and Long-Term Residential Care in the 2014 Health Accord

Universal health care is in jeopardy. Stephen Harper has been quite clear in the media that he will not meet with all of the Premiers to create a 2014 Health Accord. According to Harper the deal is already done. In December 2011, finance minister Jim Flaherty was flown into a meeting of the provincial finance ministers. He left a sheet of paper on their desks during the lunch hour which outlined the amount of money the provinces would receive in federal health transfers from 2014-2024. The paper outlined Harper government’s plan to decrease the current six per cent escalating transfer by tying it to GDP. This will reduce the transfer by $36 billion from 2017 to 2024. Provinces simply cannot afford this loss.

A Profile of Aging in Canada

According to the Canadian Institute for Health Research’s Institute of Aging, two-thirds of people who have ever reached age 65 are alive today. In Canada the segment of the population that is 65 and older is larger than it has ever been and it continues to grow. Despite these facts, Canada does not have a national strategy or plan for continuing care- home and community or residential care. This means that every province and territory is on its own to modify its policies and infrastructure to reflect our aging community. It also means that provinces/territories are on their own to fund those changes.

Data Challenges

While there are lots of reports and research on what makes communities a successful place for aging there are few pan-Canadian studies which give us an accurate picture of how Canada is doing. Try as I might, I cannot obtain statistics that show the length of waitlists and wait times for long-term care beds in each of the provinces and territories. Part of the problem is that several provinces do not collect or make public this information. And finding out about what’s happening in residential care is about to become even more challenging as Statistics Canada has had to cut their residential care survey.

Funding the necessary changes in home and long-term care

Of the research that is available, most studies show that homecare is the most affordable and desired way to care for our senior population. For those who will not have their needs met through professional care provided in the home –I use “professional care” because too often Canada relies on family members to provide care without the necessary training or skill set that may be required- publicly-supported long-term care facilities need to be available. Publicly-supported facilities are important because they charge lower rates than private for-profit facilities and are often the only option for low-income seniors. And while we know that many provinces have long waitlists for residential care placement because there are not enough beds, there are often still some empty beds in private for-profit facilities because most people cannot afford them.

Implementing changes in healthcare will cost money- although increasing homecare services could save a lot too. Yet, there is no reflection of this increased cost in the federal government’s health transfer. Several provinces including those in the Atlantic, Ontario and British Columbia are calling for federal funding formulas to consider aging populations. But provinces with young and employed workers such as Alberta aren’t on board yet.

2014 Health Accord

So what does all of this have to do with the 2014 health accord and an upcoming health ministers’ meeting?

The 2014 Health Accord should be an opportunity for the federal and provincial/territorial governments to come together and discuss how to improve Canadian health systems by protecting, strengthening and extending the Canada Health Act. This would include keeping long-term care facilities and homecare accessible by stopping the mass privatization of services and expanding public and non-profit care. But instead of looking at improvements or the needs of Canadians- such as affordable pharmaceuticals, home and community care, and free dental, mental, and vision care, the federal government has stopped the conversation before it really started. Now they’ve begun a process of meeting one-on-one with the premiers of each province and territory- the Saint John’s Telegram broke this story on August 29th.

Why do we need Harper at the Accord?

If Harper continues his one-on-one meetings with the provinces the Premiers will lose their ability to stand-up to Harper.  Financially strapped provinces will be forced to sign weaker agreements than if they had richer provinces with them. Premiers have a chance to improve health care across Canada, especially for our fastest growing population- those 80 and above- by demanding a pan-Canadian strategy on aging. They must stick together.

What is the Council doing?

The health ministers are coming to Halifax on September 27th-28th. The Council of Canadians is looking at ways to intervene and give Canadians a voice.

What can you do?

We encourage you to talk to your Ministers of Health and ask them to come to Halifax with one demand- no one-on-ones, Harper must return to the 2014 Health Accord Negotiation table. It’s time we take a stand for all generations. I finally get to win one for my parents and grandparents…and eventually myself!