Community Home Care: Hope & Reality – 2

Part 2: Demographics & Funding Factors

The stage was set in my Jan.30th blog. Community home care has four factors to consider – Medical and Accommodation as outlined, and now Demographics and Funding.

Demographics. By 2031, the estimation is that the proportion of seniors 65+ in the Canadian population will be at 23%, up from 17.3% currently. (Around then, deaths will outnumber births in Canada.) If our total population reaches the projected 40 million, that would make the 65+ population about 9.2 million. These demographic statistics form a base for figuring out what various social needs are likely to be for an aging population including community home care.

Funding. The Baby Boom generation, now retiring, is the wealthiest generation in history. Bank of Montreal economist Sal Guatieri said in The National Post July 19, 2014; that “the typical senior today is 9 times richer than the typical Millennial”. Boomers are also the generation that expects to get what it wants.

Currently, given that the number of working Canadians is declining, it is unlikely that the Boomers’ demands can be met as expected. Statistics Canada states that by 2031, the number of people in the labour market for each person aged 65+ (not working), could be lower than three. This ratio was close to 5 to 1 in 2010.

The key question is – what level of responsibility must the individual assume for their living and care arrangements? And what is the responsibility of the community or governments? Who will pay for these obligations? Can we mobilize popular support for community-based programs, or must we rely on governments for action?

Canada’s current approach to funding such programs (and many pensions, too) is “pay as you go”. This means that payments for these services are taken from current general tax revenues. If there are fewer active workers than those over 65 not working, how can we expect that programs benefiting mainly seniors will be acceptable to working taxpayers, who will want some funding room for their children’s education and family health care?

In an era of tight budgets and a future with fewer taxpayers contributing to government programs, “universality” is a problem. The Canada Pension Plan was changed from “pay as you go” to fully funded with contributions by workers who expect to benefit in the future. With pay as you go, the Boomers have no “skin in the game”. The burden is on younger taxpayer – and with a smaller number of workers/taxpayers there is enormous potential for inter-generational conflict of interests.

So far, the clamour for community home care is too broad and unfocused. I’ll set some talking points for solutions for the next post – a more refined and targeted discussion, given scarce resources now and in the future.

 

Marie Howes