Looking Into Policy Issue Brief Research Paper

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Long-Term Care Affordability: A Policy Brief Issue Affecting Canadian Health Care System

The Canadian health care system is changing, characterised by reduced hospital stays, increased outpatient treatment as well as the aging population, because of increased life expectancy, which increases long-term care demand by many Canadians. In addition, it is expected that the demand for long-term care in the country will surge radically, as the generation of baby boomers attains old age. Consequently, Canada will face a lot of challenges with regards to guaranteeing Canadians access to high quality long-term care. Carrying out structural reform that switch patients to suitable long-term care settings not only enhances patient care, but also generates substantial and efficient savings for the government. Such savings can be re-invested in various long-term care approaches in order to further enhance patient care, while addressing the shortage in funding. Considering the scale of the impending issue, action is needed right now to guarantee Canadians access to long-term care, which they will require in the future. Canada's health insurance industry seems ready to support the government as well as stakeholders in reforms that prepare the system for long-term care that meets future demands (CLHIA REPORT, 2012).

Issue Definition

Long-term care is considered a continuum of care because it begins from the time an individual needs regular assistance in areas of their everyday living, and includes both non-medical and medical care. Long-term care incorporates periodic support within the home setting and the kind of services offered within formalized health care institutions. Specialized care can range from the assistance offered when going to buy groceries or appointments to formal housing, nursing, medical, social or therapeutic treatments. Usually, people believe that long-term care applies only to the elderly and involves the kind of care that takes place in nursing homes. Although this is partly true because most of the individuals in need of help or this kind of care are seniors, they represent only a section of the entire group. There are circumstances in life, where young people need long-term care. An unexpected and debilitating illness can result in the need for a 24-hour a day care regime for an individual, despite his/her age (CLHIA REPORT, 2012).

Introduction

Long-term care is not covered within the Canadian Health Act, thus, it is not universally available for Canadians. However, most Canadians believe that their long-term health care needs would be catered for by the government. Although there exist government programs aimed at assisting Canadians with long-term care needs, such programs depend on their jurisdiction and normally rely on an individual's income. Canadians have to understand that, in most cases, they are largely liable for their long-term care costs. Policies should be in place to help alleviate the considerable stress subjected on the country's long-term care infrastructure (CLHIA REPORT, 2012). Canadians expect a sustainable and effective health care system that is not just accountable, but delivers high-quality services in the country. With the changing demographics and demand for long-term healthcare services, sustainable solutions targeting the evolving needs in the health care sector must be established (Canadian Healthcare Association, 2011).

Policy Background

Currently, long-term care is practically not covered at the federal level. According to the Romanow Report (2002), rarely does the government allude to long-term care. There are two reasons for this as shown in the report. First, the report acknowledges home care as opposed to long-term care, based on the assumption that living at home is desirable and cost effective compared to institutional care. Nevertheless, the home care services in the report are limited to palliative, post-acute, and mental health care services. Secondly, there are concerns that institutionalized long-term health care never provides the flexibility required in responding to changing population demographics as well as errors, when forecasting demand (Banerjee, 2007).

Long-term care is not part of the Canada Health Act. Hence, it is outside the commonly insured health products and services. There's a time when the Canadian federal government offered specific funding that targeted long-term care throughout the country's Extended Health Care Services program. The funds were transmitted to provinces, focusing on facilities that offer long-term care. The program was terminated in 1996 through the introduction of the Canada Health and Social Transfer program, which distorted federal transfers to various provinces, meant for health and welfare. As a result, it also eliminated the federal funding that targeted long-term institutionalised care (Banerjee, 2007). Within Canada, the territorial and provincial governments are usually accountable for delivering and managing health care. The Canadian Government supports health care delivery via financial transfers and directed programs; health care to certain populations; and finances targeting research in health, in addition to being a key player in the promotion and protection of Canadians' health.

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It also offers territorial and provincial governments with long-term funding via the Canada Health Transfer program to meet health care requirements of its populations in line with the provisions of the Canada Health Act. Funds transferred increased significantly to $28.6 billion in the year 2012-2013 from $15.3 billion in the year 2004-2005. In addition, the Government's commitment to offering sustainable, predictable and increasing federal support for long-term care is evident (Taking Action to Improve the Health of Canadians, n.d). A trivial percentage of Canadians reside within long-term care facilities (Havens, 2002). The figure for this segment of the entire population, in 1991, was 1%. Of course, residency within long-term care facilities is age related. Uncertainty surrounding the effects of shifting demographics is a main concern for long-term care planning and policy (Banerjee, 2007).

Stakeholders' Position on the Issue

The health care system in Canada is set to be strained because of the aging population that is prone to degenerative and chronic diseases. To deal with the challenges facing long-term care in Canada, it calls for a coordinated approach that links provincial, territorial, and federal governments, as well as the various key stakeholders in the health care system and the local communities. Since seniors in the country are expected to increase to ten million from five million in the next couple of years, the healthcare system will face increased demand in long-term care facilities as well as wellness and health programs. Inability to deal with these increasing demands can compromise Canada's capability to deal with the population's future health requirements (The Conference Board of Canada, 2015).

Issue Analysis

Given the different costs involved in various long-term health care settings, there can be significant cost savings and possibly better outcomes in health care once patients get treated in appropriate and conceivable low-cost settings. This foretells the concerted efforts that would be aimed at implementing important structural reforms in order to relocate people from costly hospitals into low-cost long-term care institutions, letting people live at their homes longer. Once systemic reforms transition such hospital settings into more suitable long-term care institutions, the resulting savings to the Canadian heath care system would be significant. Structural reforms that guarantee long-term care to patients no longer have to be catered for within acute care clinics, and those who can receive support within their homes would save the government so much revenue. The savings can be reinvested in a number of long-term care approaches to reduce the funding deficit while improving patient care. Costs in long-term care fall under the 'extended health care services' within the Canada Health Act; hence they can be charged partially or fully at private rates. Currently, the government provides support in long-term care (in both home and institutional care). However, current level of support is below what is necessary (Banerjee, 2007).

Although increased attention from the media and the government, in the past few years, helped, in creating awareness amongst Canadians, regarding the need for saving for retirement, there has been no proportionate focus on long-term care. Thus, Canadians face a significant peril of not being financially ready for long-term care that they may require in the future. Long-term care includes several levels of support offered via home care, informal care, as well as institutional care. It is a pity that the current system does not cover this essential aspect of long-term care. Currently, Canadians have a soiled system, characterised by poor coordination of institutional structures. Therefore, from the perspective of a patient, the health care system is very intricate to navigate. Poor coordination within the supporting institutions leads to great inefficiencies within the system, since different forms of care tend to be given without a general coordinated approach. Ensuring sufficient capacity of the system to manage the demand for long-term care is essential, as Canadians grow old. This entails the capacity of the long-term care facilities and the existence of a suitable number of professionals in the health care system to offer long-term care services, such as treatments, within the facilities (Banerjee, 2007).

Living healthy and avoiding additional support is everyone's desire. This not only maximizes satisfaction of the individual with his/her life, but also contributes to decreased costs in health care, including long-term care, which lowers the effect of costs on users. Health promotion initiates focus….....

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