Montreal – Canada’s long-term care system is under intense pressure, and the situation is projected to worsen as we begin to experience the full force of population aging. The Canadian Medical Association projects that the cost of long-term care and home care will reach $58.5 billion yearly by 2031.

A new IRPP study by Carleton University professor Frances Woolley explores options to help alleviate that pressure. The study evaluates how long-term care is financed in Canada and compares it to several international approaches. Contrary to common perceptions, much of Canada’s long-term care is currently privately financed in the form of unpaid care provided by family members, privately purchased personal care and homemaking services, and privately funded assisted-living facilities. Government funded long-term care services are tightly rationed and the waiting lists for spaces are long.

Woolley puts forward three crucial recommendations to guide the reform of long-term care financing:

• Provinces and territories should enhance transparency regarding benefit eligibility and service standards, promoting service portability and standardization.
• All levels of government should rebalance public funding for home care and institutional care, giving care recipients more flexibility in meeting their needs.
• Governments should develop a sustainable and equitable funding model that includes a comprehensive assessment of an individual’s ability to contribute to their care costs, including both income and assets rather than income alone.

“As our aging population places increasing strain on an underfunded and deteriorating public system, it’s time to dismiss the notion of better care for less cost. Financing reform is a pivotal component of any effective long-term care strategy,” says Woolley.

Woolley’s analysis provides important insights that can inform federal, provincial and territorial discussions on the pending federal Safe Long-Term Care Act, aging at home benefits and future transfer payments.

“In Canada, long-term care is a particularly challenging policy problem because there are multiple provincial, territorial and even federal systems of care provision. But this challenge can also be an opportunity for policy innovation — for experimentation with a variety of modes of financing. With 10 provinces, three territories and a federal government involved, there is a good chance that one may get it right,” Woolley concludes.

Long-Term Care Financing: What’s Fair and Sustainable? can be downloaded from the IRPP’s website (irpp.org).