Stop pretending private health care isn’t here
Retirement homes provide extra services to seniors, says John Risk.
The Ottawa Citizen’s editorial board recently encouraged us to debate the role of private payment in public health care. Dr. Monika Dutt, offering a rebuttal to that editorial, wants to shut down the debate. We can’t afford to do that, and the most compelling reason is to avoid a crisis in seniors’ care.
Seniors already outnumber children. In the coming decade, millions of people aged 65 or older will require care. The demand for elder care already exceeds supply. The need for resources and resourceful thinking to meet the demand for quality elder care will be extraordinary in the years to come. The answer thus far from the public system is more waiting or more spending promises. But the public system will never have enough long-term-care beds, home care or community supports.
As we tap our fingers on the table, private retirement homes will take up the slack. These homes increasingly offer the same level of care as long-term-care homes. Critics cry two-tier care, as if paying for services also covered by government is sinful, and overlooking the fact that people have, and should have, the ability to purchase whatever level of care they want in their own home, rented or otherwise.
Add the fact that since 2012 retirement homes must have a licence to operate and are subject to provincial standards.
Dr. Dutt resorts to the principle that access to quality care must be available to all according to need, not ability to pay. This is a worthy value. Broad access and not-for-profit delivery of health care should remain the core of our system. But in reality, thousands of low- to moderate-income seniors already lack access to quality care and accommodation through the public system. Instead, they rely on private retirement homes for levels of care beyond what the state provides.
Seniors’ care in Ontario is a mixed bag of publicly funded long-term-care homes, subsidized assisted-living facilities, public and private home care, and privately run retirement homes.
Public funding and private pay coexist, and you can get the same care in different settings. Nothing prevents a person from paying for long-term care or assisted living in a private retirement home. This eases pressure on the public health system. The editorial mentioned this, but Dr. Dutt didn’t respond to it. When we discuss universality in medicare, we tend to ignore the extent of private pay in seniors’ health services.
Retirement homes will have an increasingly important role to play in delivering health care. The time to integrate private seniors’ care into the public health system is overdue. This is exactly what the provincial government recognized in its recent announcement to test retirement home vouchers for seniors.
We are facing a tremendous increase in the number of seniors requiring health care. Private pay is already here. It is time to admit this and welcome the flexibility it brings. The logic adds up. Open the debate.