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The strengths of Canadian federalism can help end the long-term care crisis

March 10, 2021 Print

The COVID-19 pandemic has made it impossible to ignore the failings of long-term care in Canada. Despite the federal government’s promise in last fall’s throne speech to “set new, national standards for long-term care,” the provinces ultimately have jurisdiction over the area, with a wide range of policies and organizational models already firmly in place.

Any proposal that does not consider these institutional facts of life in Canada risks failure. Instead, our governments should exploit the strengths of Canadian federalism to improve long-term care, as demonstrated in a new publication from the Institute for Research on Public Policy’s Centre of Excellence on the Canadian Federation.

The paper’s author, University of Toronto professor emeritus Carolyn Tuohy, shows that the most promising path to federal-provincial cooperation can be found in two key areas where both orders of government already have a history:

  1. Old-age security – To provide both funding and harmonization of benefits, a long-term care insurance plan could be attached to the Canadian Pension Plan / Quebec Pension Plan as a supplementary benefit, providing a dedicated source of funding through the established infrastructure of joint federal-provincial management.
  2. Immigration – Federal-provincial agreement and action on immigration could help harmonize qualifications as well as working conditions of caregivers. This would have spillover effects for professional regulation, helping build a cadre of human resources in health care with commonly recognized qualifications.

“Decisive action in these areas where concurrent jurisdiction is already well established would add a set of complementary mechanisms to the existing institutional framework, rather than attempting a major institutional transfer of responsibility to the federal government,” says Tuohy.

“This is an opportunity to make once-in-a-generation changes to the policy framework for long-term care. If we do not act now, the failings that have been exposed by COVID-19 will continue to take their toll on the lives and the quality of life of Canada’s most vulnerable citizens.”


Federalism as a strength: a path toward ending the crisis in long term care, by Carolyn Tuohy, can be downloaded from the website of the Centre of Excellence on the Canadian Federation. (centre.irpp.org).

Media contact: Cléa Desjardins – 514-245-2139 – cdesjardins@nullirpp.org

Media Contact

Cléa Desjardins
Communications Director
Tel. 514-245-2139 • cdesjardins@irpp.org