Long-Term Care Sustainability as a Major Issue Affecting Canadian Healthcare System The Canadian Health Act (CHA) provides that provincial governments should cover the entire cost of hospital and physician services. There are however two components that the CHA doesn't require provincial governments to pay for including two other components of healthcare; drug costs and non-acute care provided in nursing homes and other kinds of long-term care facilities. Thus, it is up to provincial governments to decide this element of medical care. This leaves policymakers with the responsibility of using funds available to make sure that long-term healthcare needs of the elderly are taken care of (Blomqvist and Busby, 2012).

Long-term planning for non-acute care is crucial to ensure that Canada's aging population is catered for (Blomqvist and Busby, 2012). Long-term care can be defined as a continual, indeterminate (in terms of duration) care for persons who are no longer able to support themselves. Long-term attention can be classified as both healthcare as medical/nursing care and collective services like cheap housing, means of transport, ability to dress and feed independently, ability to individually and discretely use washrooms and the provision of sports and community programs (Vladeck, 2003).

Different forms of long-term care may include hospital-based long-term care, which is frequently multifaceted, more intense and short-term refers to residential-care. Hospital-care may also refer to assisted living settings which provide basic support levels and is based on the assumption that the patients being cared for are independent and do not need 24-hour attention (Banerjee, 2007). Types of long-term care may include; weekly shopping, assistance to attend to appointments, modern housing, medical examination, nurturing, communal if not, nursing, social or salutary cures. Usually, we associate long-term care with old people and nursing home. Depending on the situation, the younger or the middle-aged individuals may need continuing care in their lives. An accident or occurrence of any kind of sudden incapacitating ailment may demand a 24-hour care for individuals irrespective of their age (Canadian Life and Health Insurance Association Report, 2012).

Introduction

The report released by the Canadian senate in the year 2009 on the country's elderly population, reveals how reprehensively the elderly in Canada are being treated.

Lack of enough sufficient modern housing is making the elderly in Canada to live in isolated places with poor means of transportation.

Present income security measures are not sufficient for the current living standards and thus they cannot even cover their basic needs.

The current income structure for those who care for the elderly is not enough, and many Canadian caregivers have to choose between getting new jobs or caring for the elderly (Silversides, 2011).

The Canadian government is facing a huge challenge on finding the best methods to provide continuing care to its elderly population. The aging population is important in showing demand for the long-term care for the elderly in the years to come in Canada. Thirty three percent of the current Canadian demographic citizens are elderly citizens. As of now, close to 14% of the Canadian population is above 65 years. Going by the present analysis, it is guessed that 25% of the whole nation will be above 65 years by the year 2036. Living longer does not mean leading a good health because as we grow older, it is more likely that we will contract chronic illnesses. This means that the Canadian government may have to look for better ways to provide either residential or home-based care. According to statistics of Canada, 10%, 30% and 50% of people will need continuing care by the time they get to the age of 55, 65 and 75.4 respectively (Canadian Life and Health Insurance Association Report, 2012).

Background (literature Review)

Since the late 1980s, there have been conflicts between the provincial and federal governments and between provincial governments and their care providers. These confrontations were brought about by cost restraints and the health systems regulations. The provincial governments have two options; to either increase their use of private funding via insurance and user charges, an option, which the proposed Canada Health bill will outlaw since it has sections that prohibit such fees or the second option of increasing the government involvement in the control and management of health systems in the provinces (Vayda & Deber, 1984).

If the current annual growth rates for provincial governments' healthcare expenditures continue as predicted by the studies done by Brett Skinner at the Fraser Institute; then 60% of the provincial governments will spend more than fifty percent of the total budget on healthcare by 2020 (Skinner 2005; Skinner and Rovere 2006). These trends leave the provinces with only three alternatives: increasing income collection to cater for the increasing healthcare expenditure; decreasing healthcare costs; or cut the cost...

As of now, the last alternative seems to be implemented (McKinnon 2004).
The reasons why the healthcare charges are on the increase are well documented (Organization for Economic Co-operation and Development 2006b).These include an aging population which is piling up the pressure for both short-term and long-term therapeutic needs, new and more expensive cures, costly diagnostic methods, increase in consumer uptake, newly discovered conditions and diseases and an increasing occurrence of chronic ailments (Stuart & Adams, 2007).

Long-term care is not covered under the Canada Health Act (Alexander, 2002). Presently, long-term is practically invisible at the Canadian government level; the Romanow Report (2002), for example, barely mentions long-term care. Two reasons for its absence in the report are that the report prioritizes home-based care over long-term institutional care based on the idea that residential care is more desirable and less expensive that institutional-based care. However, residential care is only restricted to post-acute, palliative and mental health services in the Romanow Report. According to Romanow, since it is not possible to accurately predict the health needs of the Canadian population too far in the future, flexible programs should be taken including funding initiatives and facilities that might or might not be required as the Canadian demographic changes (Banerjee, 2007).

Analysis

Through Extended Health Care Services program (EHCS), the central government disbursed funds for long-term care to the provincial governments. This cost $20 per individual at the start in 1977; this rose to $51.51 by 1990s totaling to $1.5 billion yearly between 1994/5. This project however, later collapsed (Banerjee, 2007).

For long-term care to be realized, Silversides (2011) suggested the following must be checked:

Inadequate staff being the bigger issue,

Conducive working environment is important for long-term care,

Standard of living is important,

Improved expenditure on long-term and residential care,

Overworking without pay for caregivers must stop,

Residential care should be integrated into institutional care,

Palliative care is not fully funded in long-term care, and The care given should be community-based to be more effective.

Summary and conclusion

The majority of Canadians are of the viewpoint that the federal government should cover a substantial part of the long-term care costs. This position is based on the reasoning that such responsibility or funding would be a fulfillment of the government responsibility to ensure that everyone receives the set minimum standard of care, notwithstanding their socioeconomic status. In other words provision of funding for long-term care would be a fulfillment of the government responsibility of providing universal healthcare (Blomqvist and Busby, 2012). However, with limited expenditure on healthcare, as the costs of health also increase, governments will have to either escalate tax rate or cut the cost on other areas of public interest, actions, which will likely paralyze Canada's global competitive ability. Upsurge in taxation will escalate production cost, which will make life expensive in Canada. Infrastructural development and proper funding of Education are very vital in boosting the local economic growth. Loss of its competitive advantage will result in unemployment, slow rate of industrialization, inadequate skills and in the end, a failed state (Stuart & Adams, 2007).

Regardless of the argument that provision of long-term care is a matter of provision of universal healthcare or a question of whether the government has the means to do so, an important objective for the federal government would be to ensure the utilization of funds for the long-term care sector in a cost effective manner. Both the federal and provincial governments must investigate what long-term care services provide the best money value and formulate incentives and regulations to monitor the use of such services (Blomqvist and Busby, 2012).

Recommendations:

Over the last few years reports and studies have investigated the state of long-term care in Canada. Action is required at all levels to make sure that all Canadians receive the minimum standard of care regardless of their age (Canadian Healthcare Association, 2009). Policymakers are now gaining interest in the "continuum of care" as both national and local governments try to do their best to meet the care needs of the people, address unemployment, and improve productivity via integration and coordination of services (Alexander, 2002).

According to the Canadian Life and Health Insurance Association (2012), the government and stakeholders must:

Put forward measures to restructure on the health financing by transitioning at least 20% of people in long-term care facilities to residential care to have more space for more…