Provinces with more seniors should get more health care cash, doctors say

WATCH ABOVE: Taking care of our aging population is getting expensive and those costs are set to explode. Many provinces say Ottawa is not doing enough to help them deal with the costs of seniors’ medical care. As Jacques Bourbeau reports, we took their plea to the federal leaders on the campaign trail.

As Canada hands out federal health money on a per capita basis, provinces with aging populations could be in trouble.

The Canadian Medical Association fears this framework could mean those dollars aren’t going to where they’re needed most: Canada’s seniors.

Canadians 65 and over account for only 15 per cent of the population, but consume 45 per cent of health care spending, according to statistics from the CMA.

“On average a patient in hospital who is elderly will cost between two and three times as much as a younger person in hospital,” said CMA President Chris Simpson.

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Even outside hospital, elderly patients can take up additional resources.

“Many of the problems they have are complex. They may have two or more chronic diseases,” said Cindy Forbes, a family physician in Fall River, Nova Scotia.

The Atlantic provinces are particularly grey – 17.6 per cent of New Brunswickers were 65 and older in 2013, compared to just 11.2 per cent of Albertans. And with the Canada Health Transfer funding formula now calculated largely on the basis of population, those older provinces are worried they won’t be able to keep up with rising health care costs.

“We’re talking about tens of millions of dollars. This is something that’s going to have a significant impact,” said New Brunswick Health Minister Victor Boudreau.

“I certainly hope it’s not going to make it so that we are not able to provide the same level of service as other provinces are able to provide.”

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New Brunswick is already seeing the effects of an older population, Simpson said.

“They’re in sort of full-time crisis down there, with hospitals just overrun by patients who would be better served elsewhere.”

And as health care costs grow, he worries that it could crowd out provincial spending on other things, such as education and infrastructure.

“I worry about a country where one province is spending 60 per cent of its budget on health care and another that’s spending 30 per cent of its budget on health care. It’s hard to fathom how there could be a similar quality of life in those two provinces,” he said.

Changing the formula

One solution the CMA is proposing would change the Canada Health Transfer formula to take demographics into account, giving the provinces with more seniors more money to deal with the higher associated costs.

New Brunswick would like to see that kind of change, Boudreau said.

“Whether it be a top-up or an adjusted formula, something should be done so that when you’re calculating these transfers, you take into account the real needs of each province. There are different realities based on the demographics of your population.”

Conservative leader Stephen Harper defended his government’s health care funding at a media event Monday. He said the federal government has transferred record amounts of funding to the provinces, New Brunswick included.

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“In some years, we’ve actually transferred more additional dollars than the province has actually spent on health care. It isn’t even spending all that money on health care,” he said.

Not in New Brunswick, Boudreau said.

“[Harper] should check the numbers. We received $718 million in Canada Health Transfers and our budget was over $2.5 billion this year in health care alone.”

According to budget documents going back to 2009-2010, New Brunswick has consistently budgeted over $2 billion each year for health care spending, and received between $557 million and $718 million from the Canada Health Transfer.

The NDP is willing to rewrite Canada’s health accord, NDP leader Tom Mulcair said at a campaign event on Wednesday.

“I’m more than willing to sit down with the provinces and territories and come up with a new health accord,” he said. “You have to take into account the realities that can be very different from one province to the next. So it’s not one size fits all, but there are a certain number of standard things that we want to make sure we’re achieving in terms of results.”

Liberal leader Justin Trudeau said that he is willing to work with the provinces, though he didn’t specifically address the issue of health transfer payments at an event Wednesday.

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Smarter spending

The issue requires more than just money, Simpson said.

“Part of it is where we’re directing the funding,” he said. According to a report from the CMA, 15 per cent of hospital beds are occupied by people, primarily seniors, who don’t need hospital care.

That’s expensive: A hospital bed costs $1,000 a day, but home care costs closer to $55. Hospital staff are trained for acute care, not seniors’ long-term care needs, said Simpson, so seniors in hospital are not only costing the health system, they’re not getting proper care. And no one wants to live in a hospital.

“If you could suddenly snap your fingers and put all of the people who are currently in hospitals who really need to be somewhere else, in that other place, and pay for it, we’d save $2.3 billion a year just from that,” he said, citing Denmark as an example of a country which has successfully invested in home care.

Forbes says her patients would rather receive care at home.

“If you ask older patients, they will tell you that they would like to receive care closer to their home or in their home and that’s the sort of fundamental changes we’re talking about.”

“We have a system that was designed for a younger population, for acute care, hospital care of acute illness and it no longer suits the demographics of our society right now with an aging population,” she said.

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The CMA’s campaign, “Demand a Plan,” is calling on all levels of government to set goals for the health care system across Canada, with a particular focus on seniors’ needs.

“We’ve got a $220 billion health care system and nobody’s in charge. It’s crazy,” Simpson said.

“A little bit of nation building needs to be done by all levels of government on that because at the end of the day, patients don’t care what jurisdiction they’re in, they just need good care. And as taxpayers, we need to start demanding better quality care for the tax dollars that we’re putting into it.”

With files from Bryan Mullan

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