The Elephant in the Room. Funding Home and Community Care: Who Pays and How?

We believe that it is time for a serious conversation about funding a home and community care policy that parallels the Canada Health Act. Specifically: Who will pay for the system, how will they pay, and where will the money come from? We need to arrive at a consensus, and ensure that elected representatives (including future candidates for office) and public decision-makers know what we need and expect.

Stable, designated funding through general tax revenues – though politically and often personally unpopular – is the most feasible and workable approach, given the magnitude of the funds needed for a home care and community support services system. It covers the population completely and equitably and remains true to the fundamental principles of the Canada Health Act.

We summarized the various funding approaches argued for by scholars, journalists, politicians, and advocacy groups. Read about them and our other position statements here, or download our summary.

Summary of Federal Party Platforms Relating to Seniors

Care Watch calls for all parliamentarians to work together, and with provincial and territorial governments and with stakeholders, to develop, adopt and act on a national strategies that wll collectively benefit older Canadians.

Health services are, in general, provincial and territorial responsibilities, but are guided and supported by national frameworks and policies. Along with improved home care and community services, we called for two new national policy frameworks – a seniors strategy and a pharmacare strategy. Both are springboards for work with the provinces and territories.

We prepared a brief summary of the four national parties’ platforms on the three issues we identifed early in the election as critical for seniors: 1) home and community care and other services for seniors; 2) a seniors strategy; and 3) pharmacare. Platforms and promises, however, are only the bare beginnings, so we add some comments and questions about the next steps.

Brief: Summary of Federal Political Party Positions on Seniors Issues,October 27, 2019

What can you do? The 2019 federal election wasn’t an endpoint, but one step in a process. Now the real work begins.

  • Stay informed about policies affecting seniors. Check our website for more information and analysis. We will pass along what we learn.
  • Hold local representatives, leaders, and officials accountable. Don’t be satisfied with vague promises and funding announcements with no specifics. These people are accountable to you.

Basic Income vs National Pharmacare

As usual, André Picard @picardonhealth makes good points when he wonders whether a basic income strategy would be better than a national pharmacare plan. (Globe & Mail, June 25, 2019). We have long known that the way to keep people healthier longer is to ensure that they have a decent income, a roof over their heads, healthy food, a good education, a sound physical environment and sense of belonging.

It is also clear that continuing to build our “sickness care” system and medicalizing ageing at the expense of other social programming (e.g., affordable housing, community supports, etc.) is not the answer.  There are no magic bullets; no stand-alone strategies are going to address the complex range of issues that we face.

So the real choice is not either basic income or pharmacare; the choice should be “both”.

That is why Care watch is calling for both a national seniors strategy and a national pharmacare strategy, which complement our public health services system.

Let’s start where we can – using our collective economic strengths to negotiate and secure better prices and access to needed medications.  Let’s continue working on other social determinants of health: adequate income; affordable housing; nutritious food; safe environments for us to live, work and play; and social participation. #cdnpoli

Why does Canada need a National Seniors Strategy?

What’s the problem? Why a national strategy? What difference does it make to me, as a senior in Ontario?

Canada needs a national seniors’ strategy that encompasses all aspects of seniors care, including long-term, palliative and home care.

Canadians throughout Ontario and across the country are living under a health and community care system that was created at a time, 50 years ago, when the population was young and the health care needs were of an acute, short term nature. Today, with the oldest baby boomers well in to their 70s, the demographic picture is very different. Health care needs are chronic, and instead of acute care in hospitals, our ageing population requires in-home care and community support services, and long-term and palliative care.

Under the jurisdiction of the provinces and municipalities, adapting the health and community care system to address these needs is proving difficult. Availability and access to care is inconsistent across Ontario and throughout the country and is particularly problematic for First Nations, Inuit and Métis communities and for those living in rural and northern areas.

This is not just a “soft” values issue of equality of access for all Canadians.  It’s also a “hard” issue of costs to the system. Unavailability of service is ultimately very costly to us individually. Seniors who are denied access to the appropriate care or support when they need it, often end up turning to the over-burdened and expensive acute care system.  These costs are borne by us all. They also lose the ability to live full and productive lives, and thus we, as collective members of society, lose as well.

Over the years, the federal government has demonstrated that it can lead in key areas of social change, such as the delivery of health care, and the enforcement of human rights.  We need them now to set national principles and guidelines that define critical services, foster adequate provincial  funding for these services, and support and share information about innovative programs across the country so that all Canadians can benefit from new ideas and practices.

An election is a good time to let those wanting to represent us – and needing our votes – know what our interests are and to secure their commitment to act, if elected.

Call for Members of the Board of Directors

Care Watch Ontario (CW), an advocacy organization, is seeking individuals who are enthusiastic, creative and committed to enhancing the lives of Ontario’s older adults.

About the Organization:

Care Watch Ontario is not-for-profit, volunteer-run, and senior-led. We advocate for high quality, affordable, and equitable home and community care for Ontario’s elderly. We monitor provincial policy, provide analysis and feedback to decision makers, and communicate with a range of audiences, including the general public. We have no political affiliation, but work with decision makers and politicians of all stripes to achieve our central goal – a home care system that supports dignified and safe ageing.

We believe that senior citizens should be involved in decisions about policies and practices that affect their lives and the lives of their community.

Skills and Experience

We welcome applicants of all ages from the diverse residents of Ontario who support our advocacy objectives. Board members must contribute actively by undertaking organizational tasks either individually or as work group members. Work includes examining and analyzing issues, developing advocacy and communications materials for governments and the public, and making presentations. Previous work or experience with non-profit and volunteer organizations, interest in seniors’ issues, and comfort working with computers and e-mail are also assets. We encourage persons with the following lived experiences to consider applying:

  • ethno-cultural diversity
  • identification as members of the LGBTQ2+ community
  • proficiency with languages in addition to English
  • comfort working with various cultures and communities

Time Commitment

Board members make a commitment to serving a two-year term, renewable up to six consecutive years.  The Board is a working volunteer group with a time commitment of a minimum of ten hours a month. This commitment includes:

  • Attending monthly Board meetings (usually the fourth Wednesday of every month, from 10:30 am to 12:30 pm). The Board meets in Toronto, but some members may be able to participate from a distance.
  • Contribution to task or working groups and other work, as needed

Please review our web site at to better understand our issues and advocacy.

Please submit your letter of interest and resume, in confidence, to Michèle Harding, Chair, at by October 31, 2019. Only selected candidates will be contacted for an interview.

Download the Call for Board of Directors.