Since 1947 when Tommy Douglas introduced “universal health care” Canadians have struggled with healthcare – as a funding issue and as a philosophical issue. In 1990 Ontario spent $20B on healthcare. In 1999 it was $21.6B. Ten years later by 2009 it had mushroomed to $45.2B and by 2023 – that is only in another 12 years – it is expected to hit $70B or $0.70 for every $1.0 spent. The system last year saw 1.0M people, 80% of which did not need further care resources. The 20% that did faced the home care, long term care and rehabilitation “system” usually going in naively and coming out in horror.
The cross over year is 2014. In just 2 years the number of people over the age of 65 will be (for the first time) more than the number of people under the age of 14. Currently 12% of the Ontario population is over the age of 65. The life expectancy of a male Canadian is 82.1 and of a female 85.3.
There are 4700 people waiting in hospitals to be discharged to an “alternative level of care” but there is no place for them. There are 20,000 more waiting at home for a long term care facility. It is said the average wait is 65 days – but that is the average across the Province. In Toronto for a particular facility of choice the wait is generally 2 to 4 years, with 4 years more the norm.
In the case of seniors, 70% of hospital admissions relate to falls or similar injuries. Seniors represent 63% of all hospital stays in Ontario. The “frail elderly”, the elder person age 75+ with 2 or more chronic conditions* which represents 3% of the Ontario population also represents 33% of the health care dollars. One in 11 Ontarians has “Alzheimer’s”. In 25 years it is expected to be 1 in 4. That is 25% of the population. With a survival rate of 5 to 10 years with the last 5 years being the most burdensome and often requiring 24/7 care the costs can easily be overwhelming.
The demographics keep on changing: in 1980 1 senior could count on 8 family members to help. Today it is about 1 senior to 3 family members. By 2025, again in just 13 years, it is expected that there will be 3 seniors to 1 potential caregiver. You can’t even begin to calculate the cost of this unpaid caregiving.
And the costs are staggering. A few examples:
Male age 53, 3 adult children, suffers severe stroke, after being bed ridden for 9 months discharged to 24 hours PSW and 2 visits by a nurse every month. The cost? More than $18,000 a month.
Female age 41, with MS, 1 daughter who can help in the evenings and on weekend. Requires 7 hours/day care 5 days a week. Cost? $3,700/month.
Male, 83, lives with daughter who looks after him during the day. But he tends to wander at night and needs care midnight to 8am every day. Cost? $7,000/month.
Where does/is the money coming from to pay for this? Ten years of savings can be wiped out in 6 months. The increasing use of insurance will help but it is too late for those that do not have 20 years to pay for it. Other solutions are needed and now.
Lesson Learned: Is the Canadian right to healthcare absolute? Perhaps not and perhaps it never was meant to be. When Tommy Douglas spoke about “universal health care” life was simpler and “universal” had a different meaning.
*A chronic condition are common ailments including the hardening of the arteries, bone loss, high cholesterol, mental health (dementia), diabetes …
Until next time