Christine Balderas/Getty Images/iStockphoto
Concerns about an aging population, and the crisis of health-care funding, loom at the edges of public policy in Canada, and few concrete steps are being taken to address them. Two new reports put into stark relief the changes that will be required to Canada's social safety net.
Statistics Canada's population projections issued on Wednesday had one eye-catching finding. No matter which of two scenarios StatsCan used, "seniors would become more numerous than children somewhere around 2015."
Short of another baby boom or a radical change in immigrant selection, the effects are going to be lasting, and profound. A society with more people over 65 than under 15 years of age needs more seniors' facilities than schools. That in turn means more adult educators (and, of course, health-care providers), and fewer conventional teachers.
Meanwhile, a report released today by the TD Bank focuses on how to keep publicly funded health care sustainable. The aging population is one cost driver, but a larger one has been utilization, or the quantity of health services used per person, which accounts for 42 per cent of the cost increases in Ontario in the last decade.
Many of TD's ideas have a familiar ring: governments across Canada are experimenting with electronic health records, health-promotion strategies and ways to encourage collaboration among health-care workers; B.C. and Ontario are changing how hospitals are funded. Many of these ideas should work in theory, but have yet to deliver the promised savings.
The report argues that an oft-mooted idea - more private payment for health services (as opposed to private delivery of services through the public system) - runs the risk of transferring costs to private payers while draining the public system of its best resources.
Other radical fixes are available. One, a proposed user fee charged through the tax system, would be unfair. But three ideas may well need to be part of a sustainable future: paying more doctors per patient, or through a fixed salary; means-testing drugs for seniors; and creating a fund for seniors' drug coverage that people pay into while they are of working age, like today's Canada Pension Plan.
It will take some visionary political leadership even to air these proposals, and to make the existing drive for greater efficiency yield fruit. The alternative - a health-care system that still devours resources but makes every other government department go hungry - is unpalatable, and it is on our doorstep.