You can’t separate questions on the future of health care in Canada, from the reality of demographics. In the years to come, geriatric care is going to become a larger and larger portion of total spending.
Where will the money come from to complete that portion? We’ll need to decide that in a hurry.
Long-term care for seniors has become a leading wedge for increasing the level of private care in the total health care package.
And the issues involved with that are playing out pretty well as predicted.
Even though a single-payer tax-funded health-care system is acknowledged to be the most efficient — and humane — method of seeing that the most people possible get the best general health care possible, universal health care can never really be universal in a public system alone.
In a free society, there will always be people who want to choose something more. As Canada’s demographic bulge of baby boomers progresses into senior citizenship, a significant niche has grown to giving people the choices they want in long-term care.
Large, well-funded private care providers have convinced the governors of the public system that they hold the answer to shortfalls in capacity.
As predicted by critics for years, part of that answer involves paying workers less in the private system for the same work done in the public system.
A corporation can’t ask investors for hundreds of millions of dollars to build long-term care centres across the country without those investors wanting a return. In fact, a lot of them are putting their own retirement savings into companies like Symphony, which now faces an imminent strike/lockout at Symphony Senior Living Aspen Ridge in Red Deer.
There are 154 people living at Symphony Senior Living Aspen Ridge, and it takes 130 workers in a variety of jobs to care for them. The province currently funds 44 supportive living beds there, which includes beds for people with dementia. (Although Symphony now says it intends to cancel its contract with the province.)
In order to operate within the provincial funding program — plus make a profit — private care companies need to pay their workers less than they would get doing the same work elsewhere. Up to 25 per cent less, if you ask their union, the AUPE.
This is exactly what critics of privatized care have said would happen. The crux at Symphony is that we’re no longer talking about seniors and their families making choices in a free society. The public health-care system has come to depend on private care providers for long-term care for seniors.
There is no publicly-funded place for these residents to go, other than back to the costly active treatment beds at hospitals that many likely started from.
There are only four roads out of this impasse:
l Provincial taxpayers must increase the level of funding for these for-profit care facilities, sending tax dollars to pad the profits of investors.
l Symphony clients will need to pay significantly more to stay there, plus likely accept cuts to levels of service.
l Staff will need to accept wages far below what they could earn elsewhere.
l The province will eventually need to take over facilities in financial trouble, or where investors have decided to take their money out and put it into areas that provide a better return.
There is a fifth option, one proposed by the finance minister of a country whose demographic advance is somewhat farther along than Canada’s.
Taro Aso, Japan’s new finance minister, has been quoted around the globe advising his nation’s elderly to “hurry up and die.” More, he referred to seniors who could no longer feed themselves as “tube people.”
Aso said this on Monday during a meeting of a national council looking at changes to Japan’s total social security program.
More than 40 per cent of Japanese households living on welfare are over 65, in the world’s 10th most-populous country. Almost a quarter of all Japanese people are over 60. In Canada, it’s just over 13 per cent.
Aso is 72 himself, and wealthy enough to make the kinds of choices that Canada’s baby boomers want to make for that time of life when they need long-term care — which can last more than a decade.
But not all Japanese seniors and not all Alberta’s baby boomers have that luxury of choice.
In Alberta right now, if you have exhausted your savings and assets, and all you have left is Canada Pension and Guaranteed Income Supplement, you can live in long-term care with a small personal allowance, and the province picks up the rest of the tab for the bed provided for you.
Should that kind of compassion rest on the willingness of caregivers to accept substandard wages, while investors make the profits they believe are their due? We need to hurry up and decide.
Greg Neiman is a former Advocate editor.