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.

Let’s think about the new Patients First Act before jumping on or off the bandwagon!

Introduction of Bill 210, the Patients First Act, 2016 offers a key opportunity for Ontarians to assess the health system changes that Minister Hoskins proposes.  These changes will have a significant, long-term impact on the range and quality of health services Ontarians receive through our publicly funded Medicare system. They will affect our experience as users, providers and taxpayers.

The draft legislation will amend approximately 20 pieces of legislation in order to implement the proposed reforms.  The Bill is complex and the way it amends these other Acts requires careful analysis of the intent as well as effects or probable outcomes.

Care Watch has a longstanding commitment to advocate for better, more accessible home care for senior citizens.  It is through this lens that we will be watching and commenting on the proposals.

Several commentators, such as The Toronto Star’s Bob Hepburn, note that it is a “first step” in the reform and restructuring process to reduce bureaucratic barriers, improve coordination, access and geographic equity for patients; facilitate patient transitions from hospital to home care; and reduce wait times for home care services, all while re-directing spending from management to front line services.  These are high hopes indeed, but Ontarians are capable of amazing things given sufficient political will and resources!

Also, legislation alone will not change the less than healthy culture of our health care system – affecting both providers and patients – which underlies or exacerbates many current problems.  Long term improvements will require changes in the way we think of and use health services, in our expectations and requirements, and in the ethos of providers we employ.

In the short term, changes will need to be carefully synchronized with appropriate transitional funding and risk management.

There is a lot to ponder.  Care Watch encourages senior citizens to think about the proposals and share your thoughts with us.  We will offer advice to Minister Hoskins through the public legislative committee hearings that the government promises to hold.

Board of Directors, Care Watch