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Govind Rao

Medicare Per Capita Spending By Age And Service: New Data Highlights Oldest Beneficiaries - 0 views

content.healthaffairs.org/...hlthaff.2014.1371

from heather medicare statistics spending

shared by Govind Rao on 19 Jan 15 - No Cached
  • Patricia Neuman1,*, Juliette Cubanski2 and Anthony Damico3
  • Medicare per capita spending for beneficiaries with traditional Medicare over age 65 peaks among beneficiaries in their mid-90s and then declines, and it varies by type of service with advancing age. Between 2000 and 2011 the peak age for Medicare per capita spending increased from 92 to 96. In contrast, among decedents, Medicare per capita spending declines with age.
Irene Jansen

Is B.C.'s social system up to handling the wave of aging baby boomers? - 0 views

www.theprovince.com/...story.html

demographics sustainability bc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Most importantly, McGrail says, we have to rebuild the health system. That means reducing hospital infrastructure and acutecare spending to focus on investments in home care, with doctors making house calls, and building more long-term-care nursing homes.
  • The only real answer is to face the "inconvenient truth" of coming austerity -- either spending programs are reduced or eliminated, or taxes are raised, or a mixture of both, Ragan argues in his new report, Canada's Looming Demographic Squeeze.
  • In a recent paper, McGrail said the cost impact of aging is small and predictable, but the most recent research shows increases in utilization (how many and how often Canadians use health services) are twice as important as aging in increasing costs year by year.
Irene Jansen

The baby boom effect: caring for Canada's aging population. CIHI. December 1, 2011. - 0 views

www.cihi.ca/...RELEASE_01DEC11

seniors home care demographics alc ltc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • New report examines how seniors use the health system and where improvements can be made
  • Download the report: Health Care in Canada, 2011: A Focus on Seniors and Aging
  • Representing just 14% of the population, seniors use 40% of hospital services in Canada and account for about 45% of all provincial and territorial government health spending.
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  • “Although the impact of population aging on health costs has remained relatively stable over time, health care planners and providers are rightfully looking at ways to meet the needs of a growing senior population,” says John Wright, CIHI’s President and CEO.
  • opportunities for the health system to meet these changing needs, including improved integration across the health care continuum, an increased focus on prevention and more efficient adoption and use of new technologies
  • seniors spend more time in emergency departments than their younger counterparts before being admitted to hospital (3.7 hours compared with 2.7 hours in 2009–2010)
  • Seniors account for 85% of all ALC patients—approximately 85,000 cases a year. CIHI data shows that nearly half of all senior ALC patients (47%) were waiting to be moved to a long-term care facility.
  • In 2009, almost two out of three (63%) Canadians age 65 and older took 5 or more prescription drugs from different drug classes, with close to one-quarter (23%) taking 10 or more—up from 59% and 20%, respectively, in 2002.
  • in 2009, 1 out of 10 Canadian seniors was taking a drug from the Beers list, an internationally recognized list of prescription drugs identified as potentially inappropriate for use by seniors
  • 76% of seniors reported at least 1 of 11 major chronic conditions in 2008
  • 1 out of every 11 emergency department visits by seniors is for a chronic condition that can potentially be managed in the community
  • In 2008–2009, nearly half (44%) of Canada’s seniors had not had a dental check-up in the previous year.
  • Preventing falls is another important strategy to keep seniors healthy.
  • The vast majority (93%) of Canadian seniors live at home
Irene Jansen

Cognitive performance of Canadian seniors - 0 views

www.statcan.gc.ca/...11473-eng.htm

seniors home care fromdelicious

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    From Stats Can: Using data from the 2009 Canadian Community Health Survey (CCHS)-Healthy Aging Cognition Module, this study examines correlates of low performance on four cognitive tasks among Canadians aged 65 or older who were living in private dwelling
Govind Rao

Make health care an election issue - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150827|227963756

from heather federal election privatization accord

shared by Govind Rao on 27 Aug 15 - No Cached
  • National Post Thu Aug 27 2015
  • When voters are asked what issue matters most, health care once again tops the list. Yet the issue remains on life support in the current federal election campaign. As with campaigns past, it has so far failed to become a ballot question, despite the fact that it's one of the few common experiences we all share. So why is health care traditionally absent from the campaign trail?
  • There are two main reasons. First, there is the Constitution. It deems health care a provincial responsibility, essentially limiting the federal government's role to that of a giant ATM machine. When provinces deliver good health care, they take the credit; when they are unable to do so, they blame Ottawa for not transferring them enough money. Promises not only come with a price tag, but siphon money from other priorities, all without delivering political payback.
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  • The second reason is our proximity to the United States, which has served as the health-care bogeyman for over 50 years; the example of what Canada does not want to be: a place where people have to go Breaking Bad for cancer treatment. As a result, no party dares think outside the public monopoly box, or challenge the status quo. This reduces the debate to one of dollars and platitudes, which is about as appealing as hospital food.
  • But now, as the Canadian Medical Association (CMA) is warning, Canada is facing a grey tsunami, an aging population that threatens to swamp our health-care system and budgets. By 2036, 25 per cent of the Canadian population will be seniors and health care will eat up 62 per cent of public spending. Surely a crisis like that would open the door to a wider discussion of how to tackle health care, not only for this population, but all Canadians.
  • No such luck. One of the problems is that this crisis will take 20 years to fully hit us. Like a tsunami, it still looks small while it's on the horizon; only when it towers over you do you realize the full impact of the disaster. It lacks the immediacy of a terrorist attack or oil-price shock. It's also not part of a broader reform agenda, such as that undertaken by Sweden following its financial crisis of the 1990s, which led it to reform of its health-care system by introducing market mechanisms and a mix of public and private delivery.
  • But it is an immediate disaster for the millions of medical professionals, families and individuals coping with the health-care demands of aging. Their voices are being drowned out by sniping over the minutiae of the Mike Duffy trial, or announcements of boutique tax breaks for teachers or service club members. Despite an alliance between the CMA, CARP, the Alzheimer's society and others, health care remains on the back burner.
  • If providers, caregivers and seniors hope to get this health crisis more attention, they need to change how the debate is framed. It needs to be seen as a crisis of today, a crisis that moves votes, a crisis that politicians feel they need to address. They also need to advance cost-effective solutions at the front end, rather than plowing money into it at the back end. Prevention strategies, for example, could help ensure that the seniors of 2036 are healthier than those of 2015, thereby reducing budgetary strain. The middle aged middle class need to be reminded that they won't stay young forever and that they need to prepare the system for what lies ahead.
  • But advocates also need to tackle the big picture: this country's resistance to market-based provisioning of healthcare services. The Supreme Court's decision in Chaouilli v. Quebec turned 10 this month, but has not resulted in the changes many were hoping for, in terms of significantly increasing choice in the health-care system. Forget the U.S. - Canada should look to the rest of the OECD, where countries from Australia to Switzerland feature mixed health-care delivery models, incorporating public and private institutions, and payers, including public and private insurance. Many of these countries also spend less per capita than Canada, while achieving superior outcomes.
  • In other words, give the federal parties a chance to craft an original political solution, rather than simply throw more money at the problem. Just as the Canada Health Act served as a legacy piece for the Liberal government of 1984, new health-care legislation could become a hallmark of whatever government holds the reins after Oct. 19. More importantly, It could ensure that the health needs of the aged, and all Canadians, are met for generations to come.
Govind Rao

The median cost of a US nursing home tops $91,000 a year, forcing families to reconside... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wcpa|20150720|225269556

from heather us ltc insurance seniors dementia costs privatization

shared by Govind Rao on 21 Jul 15 - No Cached
  • Canadian Press Mon Jul 20 2015
  • NEW YORK, N.Y. - Doris Ranzman had followed the expert advice, planning ahead in case she wound up unable to care for herself one day. But when a nursing-home bill tops $14,000 a month, the best-laid plans get tossed aside. Even with insurance and her Social Security check, Ranzman still had to come up with around $4,000 every month to cover her care in the Amsterdam Nursing Home in Manhattan. "An awful situation," said her daughter, Sharon Goldblum. Like others faced with the stunning cost of elderly care in the U.S., Goldblum did the math and realized that her mother could easily outlive her savings. So she pulled her out of the home. For the two-thirds of Americans over 65 who are expected to need some long-term care, the costs are increasingly beyond reach. The median bill for a private room in a U.S. nursing home now runs $91,000 a year, according to a report from the insurer Genworth Financial. One year of visits from home-health aides runs $45,760.
  • Goldblum estimates that she and her mother spent at least $300,000 over the last two years for care that insurance didn't cover. "If you have any money, you're going to use all of that money," Goldblum said. "Just watch how fast it goes." How do people manage the widening gap between their savings and the high cost of caring for the elderly? Medicare doesn't cover long-term stays, so a large swath of elderly people wind up on the government's health insurance program for the poor, Medicaid. For those solidly in the middle class, however, the answer isn't so simple. They have too much money to apply for Medicaid but not enough to cover the typical three years of care. Some 60 per cent of Americans nearing retirement - those between the ages of 55 and 64 - have retirement accounts, according to the Employee Benefit Research Institute. The median balance is $104,000.
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  • Combined with other savings and income, that amount might provide some retirees with all they need for decades. But everything changes when, for instance, an aging father struggling with dementia requires more help than his wife and children can manage. Plans that looked solid on paper are no match for their bills. "Within the first year most people are tapped out," said Joe Caldwell, director of long-term services at the National Council on Aging. "Middle-class families just aren't prepared for these costs." Many who can afford it buy insurance to help pay for long-term care years in advance, when insurers are less likely to reject them. But even those with insurance, like Ranzman, come up short. Forced to improvise, they sell the house and lean on family. They move in with their adult children, or arrange for their children to move in with them.
  • Some can save money by switching to different facilities. On average, a shared room in a nursing home runs nearly $11,000 a year less than a private room, and a room in an adult-family home runs cheaper still. Still, there's not a lot of room for creativity, said Liz Taylor, a self-employed geriatric care manager in Lopez Island, Washington. "The amount of care you need dictates the price," she said, "and there aren't that many ways around it." Hiring an aide to spend the day with an elderly parent living at home is often the cheapest option, with aides paid $20 an hour in some parts of the country. But hiring them to work around the clock is often the most expensive, Taylor said. "Needing help to get out of bed to use the bathroom in the middle of the night means you need a nursing home," she said.
  • EVICTED To Roslyn Duffy, it seemed that her mother, Evelyn Nappa, had everything she needed. After a stroke made it difficult to live alone, Nappa moved from Arizona to Seattle to be near her daughter and soon settled into The Stratford, an assisted-living facility, where she quickly made friends of fellow residents and the staff. "The care was great," Duffy said. "We loved that facility." With the sale of the house in Arizona, Nappa's savings appeared sufficient to cover 10 years at The Stratford, enough to last until she reached 100. Duffy said that the home's directors told her not to worry about her mother running out of money and winding up on Medicaid, even though the government program pays just a portion of what many facilities charge. After all, many of the same homes that refuse to admit seniors on Medicaid will keep those who spend all their savings and wind up on the program. "'We will keep her here' - that's what they said," Duffy recalls. "But I didn't get that in writing." A representative from the nursing home declined to comment.
  • As Nappa's dementia progressed, she needed more attention. That meant moving her from an independent unit that cost $3,000 a month, to a dementia unit that cost $6,000. Trips to the emergency room, hearing aids and other costs that Medicare didn't cover added up. Soon enough, the money that was supposed to last 10 years was gone in two. Duffy enrolled her mother in Medicaid, confident that The Stratford's management would keep its promises. Two months later, she received a letter saying her mother had 30 days to find a new home. Duffy protested, writing letters to the management and local newspapers, and succeeded in keeping her mother at the Stratford for two months until social workers helped line up an adult family home willing to take Medicaid payments.
  • But the stress and the change of surroundings strained her mother's health, Duffy said. Six weeks after moving, she was dead. "She declined so quickly," Duffy said. "Being in familiar surroundings is hugely important for dementia patients. There's no doubt in my mind that the move hastened her death. It was devastating, just devastating." NEW HOME Ranzman's story has a happier ending. Her daughter pulled her out of the Amsterdam Nursing Home and rented a house in Smithtown, Long Island, with a patio and a backyard full of azaleas and trees. It was Ranzman's own space. She had round-the-clock aides, a large window and plenty of sunlight. Her daughter, Goldblum, noticed that Ranzman's memory improved quickly. Her mother seemed happier and more alert. "It was less than half the cost of a nursing home and a million times nicer," Goldblum said. "She showed such improvement." Goldblum paid $36,000 a year for the house and her mother's long-term care insurance paid the home-health aides. The move saved around $250,000 a year in expenses. What's more important to Goldblum is that her mother seemed content when she died in April at age 86, lying in bed and surrounded by family. "It was a wonderful ending," she said.
Govind Rao

Health spending won't meet needs of aging Canadians, report warns - The Globe and Mail - 0 views

www.theglobeandmail.com/...article25601774

from heather spending accord seniors research

shared by Govind Rao on 21 Jul 15 - No Cached
  • Tuesday, Jul. 21, 2015
  • Spending on health care has slowed in recent years, and under the current federal policy will not meet the challenges of an aging population, the Parliamentary Budget Officer says in a new report.The Fiscal Sustainability report, which was released Tuesday, examines whether the spending plans by the various levels of government are viable in the long term, given anticipated economic and demographic challenges.
  • The independent office responsible for assessing the country’s finances says limits imposed by the federal Conservative government on increases to health transfers will eventually make it impossible for provinces and territories to handle the costs of an aging population.
Govind Rao

Provinces will need more money; Politicians gloss over impact of aging population - Inf... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150722|225360055

from heather accord pbo federal provinces

shared by Govind Rao on 22 Jul 15 - No Cached
  • National Post Wed Jul 22 2015
  • The fiscal imbalance is back. The Parliamentary Budget Office has just released a report on fiscal sustainability that questions whether public debt is likely to grow faster than the economy in the coming decades. The answer is reassuring for federal governments. If all the PBO's assumptions come to pass, there is no need for major corrective policy action and the federal net debt will be eliminated over the next 35 years. This gives Ottawa the opportunity to increase spending or reduce taxes by up to 1.4 per cent of gross domestic product every year (about $28 billion next year) and still maintain net debt at current levels (34.1 per cent of GDP).
  • The Conservatives have committed themselves to reducing the debt and balancing the budget, but the PBO's report suggests that the Liberals and NDP could conceivably argue there is room to stimulate the economy without raising long-term debt levels. It would, though, require them to run deficits and neither Tom Mulcair nor Justin Trudeau has yet dared to suggest they would breach the new balanced budget law. At the provincial and territorial level, the news is less rosy. Provincial governments have done a good job in containing health spending in recent years, after decades of galloping inflation. Recent evidence suggests that spending growth is coming in below GDP. But the demographics of an aging population are set to defeat all attempts at cost containment. The report points out that the old age dependency ratio is sliding into the grey - in 2014, there were 4.3 people aged 15-64 for every one over 65; by 2034, that number will fall to 2.6 people and reach 2.1 by 2090. Health-care spending is forecast to rise over that period from 7.2 per cent of GDP to 12.5 per cent.
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  • The PBO estimates that provincial governments need to find savings or revenue increases of 1.4 per cent of GDP to put themselves back on a sustainable footing. Coincidentally, the amount the provinces are short is about the same as the feds have in fiscal room. This was the essence of the fiscal imbalance argument back in 2006, when Prime Minister Stephen Harper argued that a transfer to the provinces was required. He lost his enthusiasm for the project in 2007, when he handed a $700-million cheque to then-Quebec premier Jean Charest, who promptly gave it away as a pre-election tax cut/bribe. Not only have the Conservatives not mentioned the words "fiscal imbalance" since then, they are entirely to blame for its return to the political landscape.
  • In 2017, the $32-billion Canada Health Transfer will only grow at the rate of general growth plus inflation - about three to 3.5 per cent. Provinces have been used to six per cent increases since Paul Martin signed his "fix for a generation" with the provinces in 2004. This shift, announced by the Harper government, is a significant contributor to the fiscal gap the provinces are set to experience in the years ahead. The NDP has promised to maintain the six per cent escalator, which according to the PBO numbers, it has the fiscal room to do, without sending debt levels into the stratosphere. But it cannot also balance the federal budget. The federal election campaign is obviously not the crucible in which to debate serious long-term policy issues. But the next government in Ottawa is going to be forced to address the cost implications of a world where the average male lives an additional eight years by 2065. Provinces are reducing costs and have the option of increasing their own taxes. But the data are persuasive - the feds have too much money and the provinces not enough.
Govind Rao

Long-term care worries aging clients | Advisor.ca - 0 views

www.advisor.ca/...e-worries-aging-clients-188934

from heather ltc continuing care

shared by Govind Rao on 02 Sep 15 - No Cached
  • August 31, 2015
  • What worries aging Canadians as they prepare for long-term care? A BMO Wealth Institute study finds that the greatest health-care-related aging concerns include: losing the ability to live independently (40%); not having enough money to pay for adequate health care (17%); and not being able to afford to remain in their own homes throughout their lifetimes (15%).
Govind Rao

Effect of older age on treatment decisions and outcomes among patients with traumatic s... - 0 views

www.cmaj.ca/...cmaj.150085

from heather ageing seniors waits equity

shared by Govind Rao on 08 Jul 15 - No Cached
  • CMAJ July 6, 2015 First published July 6, 2015, doi: 10.1503/cmaj.150085
  • Interpretation: We found chronological age to be a factor influencing treatment decisions but not at the 70-year age threshold that we had hypothesized. Older patients waited longer for surgery and had a substantially higher in-hospital mortality despite having less severe injuries than younger patients. Further research into the link between treatment delays and outcomes among older patients could inform surgical guideline development.
Govind Rao

Summary of CFNU's Parliamentary Breakfast on An Aging Population | Canadian Federation ... - 0 views

nursesunions.ca/...ary-breakfast-aging-population

from heather nursing union pharmacare

shared by Govind Rao on 24 Mar 14 - No Cached
  • On February 4, 2014, the Canadian Federation of Nurses Unions hosted a breakfast meeting on Parliament Hill to discuss An Aging Population, Prescription Drugs and the Future of Public Health Care in Canada, with presentations by Mr. Cal Martell and Dr. Steven Morgan. Members of Parliament, Senators and a wide range of health and labour stakeholders came together to hear expert speakers address the challenges and realities of an aging demographic, coupled with the rising costs of prescription drugs in Canada.
Govind Rao

New poverty reduction strategy calls for guaranteed income for more than just seniors -... - 0 views

www.digitaljournal.com/1647760

from heather determinants poverty seniors

shared by Govind Rao on 19 Dec 13 - No Cached
  • Dec. 18, 2013
  • CALGARY, Dec. 18, 2013 /CNW/ - Guaranteed annual income programs for seniors are a policy success story for Canada as it boasts one of the world's lowest poverty rates among the elderly. A new report funded by the Canadian Institutes of Health Research and released by The School of Public Policy recommends these programs be extended to a much larger age group. "The government could go a lot further toward the reduction of poverty in Canada by building on the success of its income supports for seniors, and making them available to poor Canadians of all ages," authors Herb Emery, Valerie Fleisch and Lynn McIntyre write. Of course, this move would be a reversal in policy given that the federal government is currently phasing in a plan to raise the age of eligibility for Old Age Security from 65 to 67.
Govind Rao

Are Income-Based Public Drug Benefit Programs Fit for an Aging Population? - 0 views

irpp.org/...study-no50

from heather pharmacare drugs

shared by Govind Rao on 11 Dec 14 - No Cached
  • Steven G. Morgan, Jamie R. Daw and Michael R. Law Provinces should provide full and universal pharmacare December 3, 2014
  • Medications prescribed outside a hospital setting are not covered by Canada’s medicare system. They are financed through a patchwork of private and public drug insurance plans that only provide coverage for select populations, leaving many Canadians with little or no coverage. Up until the late 1990s, people 65 and older received universal, almost first-dollar public drug coverage in most provinces. But with population aging, the public liability associated with age entitlements has become a major concern for governments. Four provinces have discontinued their age-based programs, which covered most of the cost of medications for seniors, and -replaced them with income-based programs, which protect all residents against catastrophic drug costs. Other provinces have started to move or are considering moving in this direction.
Govind Rao

Saving costs, hurting families - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150313|216302039

from heather Quebec cuts

shared by Govind Rao on 13 Mar 15 - No Cached
  • National Post Fri Mar 13 2015
  • Gaetan Barrette, Quebec's Minister of Health, recently announced proposed legislation that would change how the province funds in vitro fertilization (IVF) for women unable to conceive without medical assistance. Women would have to sign a declaration stating that they had been sexually active for a sustained period, and were still unable to become pregnant. Women over the age of 42 would not be eligible for IVF at all. Minister Barrette, I would like to introduce you to Mikey, my little boy. I had him when I was 43 and I am not alone. The trend toward later motherhood is significant in most Western countries today. The proportion of Canadian women giving birth in their early forties has doubled since 1988, and in the U.S., it has quadrupled. The decision when to have a child is very personal. It is also widely acknowledged that women today are under tremendous social pressures to "be responsible," complete their education and establish financial and relationship stability prior to starting a family. Having a child later in life is not always a mere preference; often it is the result of how our current social structure limits the choices open to women. But by the time it is "socially responsible" to have a child, it may become biologically challenging. Our fertility declines and we are racing against our biological clocks. This is precisely when some need the assistance of IVF to conceive.
  • I am not certain why you chose 42 as a threshold (perhaps you are relying on policy advice from Douglas Adams' Hitch Hiker's Guide to the Galaxy, that suggested "42" is the answer to the meaning life). But this age threshold discriminates between women who are lucky enough to conceive spontaneously in their forties, and those who need assistance. It also discriminates between me and my husband, for whom there is no age limit in your Bill. Is it medically riskier to have a baby after 40? Yes, it is. Does the risk justify not having a baby? In most cases, it does not. And in almost all cases, this is a decision that a woman should have the liberty to make for herself. Women are making much riskier decisions without government intrusion, such as undergoing plastic surgery. They are making them for more trivial reasons than the desire to bring a child into the world.
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  • Your proposed Bill 20 is meant to improve health-care access and cut costs in Quebec. But by banning access to IVF for women over 42, it is overstepping its objectives and violating the rights of citizens. Choosing to limit public funding for a service, when trying to save money, is one thing; but banning it completely, even when people choose to pay out of their own pockets, is an entirely different matter. When you were recently challenged on this point, you said that this is not a matter of cost but rather of "protecting mothers and children." My son and I are doing very well, thank you for your concern. And like other mothers who conceived in their 40s, I would appreciate some respect for my autonomy. This justification of 42 as an age limit for IVF is good old-fashioned paternalism that has no place in today's society. Under the guise of protection, this Bill represents an attack on Quebec women and mothers.
  • To make things worse, Bill 20 is threatening physicians with heavy fines if they direct me to another province or jurisdiction where I can privately access IVF after 42. This is an alarming violation of the professional autonomy of a doctor to refer patients, not to mention a violation of a woman's freedom to have access to health information she needs. In 2010, the Quebec government introduced a program that funded every aspect of IVF for everyone, an unprecedented level of coverage in North America. The program was in such high demand that it cost much more than expected, $261 million to date. Looking back, there is wide agreement in Quebec that the hasty introduction of the program in the absence of reflection and public consultation led to very problematic consequences. You, Minister Barrette, famously criticized this program for being an "open bar" and allowing access to IVF without appropriate restrictions.
  • But the fix for bad policy is not another bad policy. Proposing ethically and socially appropriate conditions of eligibility for publicly funded IVF is a laudable objective. The thoughtful and well-argued report published in June 2014 by the Quebec Commissioner for Health and Well-being, based on an extensive public consultation, proposes many such conditions that would allow cutting costs while respecting considerations of justice and equity. Conditions on access to public funding may be justified.
  • But there is no way to justify draconian measures that have nothing to do with cost control, but are rather an affront to women's rights. Rather than protecting us from IVF, you should protect us from unwarranted government intrusion. Vardit Ravitsky is an associate professor in the Bioethics Program at the School of Public Health, University of Montreal.
Govind Rao

Health care system to feel strain of aging population: Report | News1130 - 0 views

www.news1130.com/...ain-of-aging-population-report

from heather seniors budget

shared by Govind Rao on 17 Apr 15 - No Cached
  • April 15, 2015
  • If something isn’t done now, our health care system will be in big trouble 25 years from now, that’s the finding of a report from the Conference Board of Canada. It says the number of seniors in the country is expected to double between now and then, from 5 million to 10 million, and Dr. Gabriela Prada, who is one of the study’s authors, says most of us are unaware of the consequences.
  • She points out as the number of seniors increases, so will the demand for hospital services, home care, and long-term care and the current system is already struggling. “The health care costs per capita tend to increase every year of life after 65, so it’s not only the volume of seniors but also the seniors aging within that population that is going to have a very important impact on health care costs. But then, at the same time, there are some other consequences of aging, so there will be a reduction in Canada’s labour pool because there will be less people working and that will impact our health human resources and likely will aggravate some of the shortages that exist today within health care services.”
Govind Rao

Aging and Health Care Costs: Narrative Versus Reality - Kingsley - 2015 - Poverty & Pub... - 0 views

onlinelibrary.wiley.com/...F2A9421A59C90A42E288E43.f02t02

from heather costs seniors funding ageing

shared by Govind Rao on 23 Mar 15 - No Cached
  • David E. Kingsley
  • Poverty & Public PolicyVolume 7, Issue 1, pages 3–21, March 2015
  • This study documents the widespread belief among the public, “pundits,“ and policymakers that health care inflation in the United States is heavily influenced by longevity. It demonstrates the error of that belief. It points out that health care experts recognize that, although health care costs for the elderly are high, the aging of the population is an insignificant factor in health care cost inflation. Nevertheless, existing literature tends to ignore important influences on cost, such as poverty, lack of access, lifestyle issues, and matters of social justice. It also ignores the differences among numerous subgroups of patients. Ignoring these factors and concentrating on an aging society as a major cause of health care inflation distracts policymakers' attention from the true causes and leads to unjustified calls for benefit reductions in Medicare. As part of this study, the author includes analyses of hospital discharge data that have not been published previously.
Irene Jansen

Health ministers mull more home care | The Chronicle Herald - 0 views

thechronicleherald.ca/...-ministers-mull-more-home-care

Council of the Federation innovation home care drugs purchasing

shared by Irene Jansen on 18 Mar 13 - No Cached
  • TORONTO — Provinces and territories will likely have to expand home care as a way to deal with the demographic deluge of aging Canadians, two premiers said Friday during a gathering of provincial health ministers.
  • Provinces and territories will likely have to expand home care as a way to deal with the demographic deluge of aging Canadians, two premiers said Friday during a gathering of provincial health ministers.
  • An aging population was at the top of the working group’s agenda as a major concern because it’s consuming more health-care dollars, said P.E.I. Premier Robert Ghiz.
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  • There aren’t enough nursing home beds to accommodate the surge of seniors needing care, so home care may be the solution, said Saskatchewan Premier Brad Wall.
  • The working group, which Ghiz and Wall both lead, is also making progress on lowering the cost of prescription drugs, they said.
  • Several provinces and territories reached a deal in January to team up when purchasing six widely used generic drugs, which will collectively save them about $100 million a year, Wall said.
  • They’re also looking at brand-name drugs and will have more to say about it in July at the Council of the Federation meeting in Niagara-on-the-Lake
  • The provinces have agreements for seven brand-name drugs and they’re negotiating prices for 13 others, said Ontario Health Minister Deb Matthews.
    • Irene Jansen
      Irene Jansen on 25 Mar 13
       
      bulk purchasing agreement among the provinces covering 27 prescription drugs. There are approximately 6500 prescription drugs on the Canadian market, with about 80 new drugs coming on to the market each year. So only about 6475 drugs to go - this year. CF
  • The working group also talked about “appropriateness of care” — ways to make the health-care system more efficient and cut down on soaring costs. “The radiologists in this country have said 10 to 20 per cent of diagnostic imaging is probably not required,” Wall said.
  • There might be other suggestions from providers, in terms of cataracts
healthcare88

Inviting community inside; Nursing homes are trying to reduce social isolation of senio... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|vapr|20161030|259467472

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shared by healthcare88 on 31 Oct 16 - No Cached
  • The Province Sun Oct 30 2016
  • Despite a 95-year age difference, five-year-old Tony Han Junior and centenarian Alice Clark enjoy each other's company. After decorating Halloween cookies together, Han brings his own masterpiece, smothered in smarties and sprinkles, to Clark and encourages her to try it. Few words are exchanged, but smiles and giggles are constant at the intergenerational program at Youville Residence, a long-term care facility for seniors in Vancouver. Han Jr. is among a half dozen children visiting this day from the Montessori Children's Community - a daycare located on the same site as Youville, at 33rd and Heather.
  • Despite a 95-year age difference, five-year-old Tony Han Junior and centenarian Alice Clark enjoy each other's company.
  • ...12 more annotations...
  • After decorating Halloween cookies together, Han brings his own masterpiece, smothered in smarties and sprinkles, to Clark and encourages her to try it. Few words are exchanged, but smiles and giggles are constant at the intergenerational program at Youville Residence, a long-term care facility for seniors in Vancouver. Han Jr. is among a half dozen children visiting this day from the Montessori Children's Community - a daycare located on the same site as Youville, at 33rd and Heather.
  • Montessori Children's Community administrator Kristina Yang said it's a win-win situation. "Even if there is not a lot of communication with words you can see the beautiful smiles on everyone's face. Many of the children come to know a lot of the seniors and when they pass by our window they'll be excited waving and saying 'Hi ,'" Yang said.
  • Youville occupational therapist Sheralyn Manning said the children's visits are a big part of the seniors'day. Besides planned events, such as doing crafts together, every so often the children will visit when the weather is bad and they are not able to play outdoors. Manning pointed out the friendship between Clark and Han has been particularly touching to watch and Clark has a recent craft project Han gave her prominently displayed in her room. When most people think of nursing homes the image that comes to mind is a stand-alone building offering residential care only for the aged.
  • It's a place seldom visited unless you are a family member, friend or volunteer. But these days more homes are trying to build bridges to the wider community. Of B. C.'s 460 government and private nursing homes, only a handful have daycares or doctor's offices on site, said Daniel Fontaine, CEO of the B. C. Care Providers Association, which represents 60 per cent of the privately-operated homes. But none are attached to a facility that offers a large variety of community services. One of the best Canadian examples of a nursing home that achieves just that, said Fontaine, is Niverville Heritage Centre, near Winnipeg. It is home to 116 seniors but is also a gathering place for major community events.
  • The centre hosts 100 weddings each year. As well, about 50,000 visitors drop in at the centre annually to access their doctor's office, dentist and pharmacist or visit the full-service restaurant and pub. "We found seniors don't want to be retired to a quiet part of the community and left to live out their lives. They want to live in an active community and retreat back to their suite when they want that peace and quiet ," said Niverville Heritage Centre's CEO Steven Neufeld.
  • Before the centre opened in 2007, he said, members from the non-profit board that operates the centre visited traditional nursing homes and discovered that the lounges that were built for seniors were seldom used. "I remember going to one place where there was a screened-in porch that was packed. The seniors were all there wanting to watch the soccer game of the school next door ," he said. Having services like doctors'offices, dentists, a daycare, a full-service restaurant, and hair styling shop on site fulfil the centre's mission of being an "inter-generational meeting place which fosters personal and community well-being." Fontaine said it's worth noting that Niverville was able to "pull all of this together in a community with a population of less than 5,000 people." He hopes more B. C. nursing homes follow Niverville's lead.
  • Elim Village in Surrey, which offers all levels of residential senior care on its 25-acre site, is on that track. There are 250 independent living units, 109 assisted living units and 193 traditional nursing home beds. The village also has a 500-seat auditorium, located in the centre of the village, that hosts weddings and is available for rent for other public events. Elim Village also rents out space in one of its 10 buildings to a school, which allows inter-generational programs to take place easily between students and seniors. Another "continuing care hub " at Menno Place, in Abbotsford, has a public restaurant called Fireside Cafe, popular with staff from nearby Abbotsford Regional Hospital and Cancer Centre. There's also a pharmacy and hairdresser on its 11-acre "campus " site but these services are available only to the 700 residents and staff. "We purposely try to involve the community as much as possible ," said Menno Place CEO Karen Baillie. "It's Niverville on a smaller scale." She said Menno Place partners with high schools and church groups and hundreds of volunteers visit regularly. "Seniors are often challenged with isolation and fight depression. That's why we have different programs to encourage them to socialize ," she said.
  • Research shows 44 per cent of seniors in residential care in Canada have been diagnosed with depression, and one in four seniors live with a mental health problem, such as depression or anxiety, whether they live in their own home or are in residential care. A 2014 report by the National Seniors Council found socially isolated seniors are at a higher risk for negative health behaviours including drinking, smoking, not eating well and being sedentary. The report also found social isolation is a predictor of mortality from coronary disease and stroke, and socially isolated seniors are four to five times more likely to be hospitalized.
  • Since more seniors now remain in their own homes longer those who move into care homes are often more frail and need a higher level of assistance, said Menno Place director of communications and marketing Sharon Simpson. Seniors with dementia, in particular, can be socially isolated as friends and family often find it more difficult to visit them as they decline, she said. But Simpson said an intergenerational dance program, run by ballet teacher Lee Kwidzinski, has been a wonderful opportunity for seniors with dementia to be connected to the community. The program is also offered in four other nursing homes in the Fraser Valley. "For them it's an opportunity to see children. You can see the seniors come to life, smiling and giggling at the girls'antics. It's very engaging ," she said. "Some may not be verbal but they are still able to connect. They feel their emotions and they know whether someone is good to them. They feel these girls and become vibrantly alive. It's one of the most powerful things I've ever seen."
  • Creating community connections is key as Providence Health begins its planning stage to replace some of its older nursing homes in Vancouver, said David Thompson, who is responsible for the Elder Care Program and Palliative Services. Providence Health operates five long-term-care homes for approximately 700 residents at four different sites in the city. "It's always been our vision to create a campus of care on the land ," said Thompson, of the six acres owned by Providence Health where Youville is located.
  • He said the plan is to build another facility nearby, with 320 traditional nursing home beds. One of the ways to partly fund the cost is to include facilities that could be rented out by the larger community, which would be a benefit to the seniors as well, he said. There is already child care on site, and future plans to help draw in the community include a restaurant, retail space and an art gallery. He said another idea is to partner with nearby Eric Hamber Secondary School by providing a music room for students to practise.
  • "Cambie is at our doorsteps. If you have people coming in (to a residential care facility) it brings vibrancy and liveliness ," Thompson said
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Free and timely health care for all is fiction: Neil Macdonald - Politics - CBC News - 0 views

www.cbc.ca/...by-boomers-macdonald-1.3833563

privatization medicare day

shared by healthcare88 on 03 Nov 16 - No Cached
  • How the system fails to live up to Canada's half-century-old social compact
  • Nov 03, 2016
  • Earlier this week, Quebec's stolid health minister stood outside Montreal's dysfunctional new mega-hospital and effectively predicted what lies ahead for aging baby boomers.
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  • Hospitals have fixed budgets and must not run over them the way the mega-hospital has been doing, Gaétan Barrette warned. You can't just keep accepting patients and treating them once the money has run out. It won't be tolerated.
  • Barrette, who is a doctor himself, might not be the canniest of politicians. Usually, Canada's elected leaders at least publicly play along with the fiction that every Canadian receives proper treatment, free of charge, in a timely manner.
  • First, there is no "Canadian health-care system." There are a bunch of health-care systems, one per province, with all the inherent inefficiencies that suggests, partially funded by the federal government, which is supposed to oversee things, but gave up ages ago.
  • The Conference Board of Canada says that if you live in Ontario, you get better health care than you do if you live in Quebec, where you will pay far higher taxes.
  • Second, the system is somewhat corrupt; if you have influence or an elite education or some "in," you'll get better care than a fellow who doesn't.
  • None of that, of course, is to mention all the Canadians who head to an American city (or somewhere like India) and pay, in order to circumvent Canadian waiting lists for other procedures.
  • Third, the idea we'll be cared for in our dotage is aspirational, not anchored in law.
  • The oldest boomers are now 70, and it's at age 75 that people really start to soak up medical care. So will the system expand to accommodate the surge in need that's coming?
  • Livio Di Matteo, a health-care economist at Lakehead University
  • Canadian law actually forbids the private purchase of medically necessary care.
  • But everyone knows you can pay for a private MRI scan in many parts of the country if you don't want to wait nine or 10 months or longer for one in a hospital.
  • And if you don't want to languish in unbearable pain, there are places in Canada where you can buy a private hip replacement or orthopedic surgery. By and large, the federal government just pretends it doesn't see.
  • The federal government, which has been increasing its health-care transfers to the provinces by six per cent a year, wants to cut back, claiming the provinces haven't been spending it all on health care anyway.
  • As Di Matteo puts it: "If you are willing to let people cross the border and do it, why not give them the option in Canada, where they live" and save them the trip?
  • Doctors remove a cyst from a male patient's knee at the Cambie Surgery Centre, a private clinic in Vancouver that's at the centre of a landmark case before the B.C. Supreme Court. (Darryl Dyck/The Canadian Press)
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