Since the 1970’s, government policy makers have acknowledged that baby boomers will eventually strain our health and long-term care system.
That time has come. And we’ve taken little action to prepare for it.
Today, we are living longer and our healthcare infrastructure is even more expensive. The Canadian Institute of Health Information (CIHI, 2016) reports that the average Canadian aged 15-64 incurs about $2663 per year in healthcare costs. When Canadians reach the age of 65 and older, that average annual cost jumps to $11,635 per year.
Those costs come from physician offices, emergency departments, joint replacements, cataracts, cardiac disease, chronic diseases, special care, nursing care, and nursing homes.
As a senior, I won’t apologize for the cost burden that diseases of aging create. But I do get extremely impatient, sometimes downright angry, at the glacial pace of change in the health and long term care systems to accommodate that which has been known and forecast for 40 years!
I know better than most that change in healthcare is not for the faint of heart. In 1992, the NB provincial government took dramatic steps to modernize the health and social system in NB by commencing with regionalizing hospitals. Politicians and healthcare leaders paid a political price– the McKenna government lost a few seats in the 1995 election and some of us who were in the leadership ranks were sent away!
But it was the right thing to do and we knew it. NB is a very small province and the health and social service system can and should be managed with a much smaller infrastructure than in the past. The goal in 1992 was more efficient care with less infrastructure.
Unfortunately, commitment to that plan did not survive ensuing governments.
In 2015, I was asked to co-chair the New Brunswick Council on Aging along with distinguished professor Dr. Suzanne Dupuis Blanchard. When the Minister asked if I would serve, I asked the question: “The system of care for Seniors is broken at so many levels and has been for a very long time—we don’t need another report that sits on a shelf. Can you promise me that if we come up with some plausible strategies, government means business?”
I was assured that government wanted meaningful change so I agreed. Seasoned analysts have said that if you get Senior Care right, you have largely fixed the health system. Heartened by the Strategic Program Review already in place, I was (perhaps naively) hopeful that Government was ready to roll on change.
For over a year, 17 people came together with a number of civil servants and consultants to develop the plan we presented to government on January 27, 2017. Our report was praised by stakeholders both within and outside New Brunswick. Some of us recommended that a small, informed group be asked to work with the Deputy Ministers of Health and Social Development in prioritizing the 70+ recommendations and helping with the challenge of implementation and follow up.
Instead of concrete action, government chose to establish yet another discussion forum comprised of over 60 people with zero decision-making power. Only three members had served on the Aging Council. It was like starting from scratch, as though a year of consultation, study, and consensus-building had not taken place.
Experienced, knowledgeable people in the health and long-term care field know there are about a dozen issues that, if fixed, could improve senior care by leaps and bounds. Also importantly, these measures would relieve pressure on our hospital system where, on any given day, over 400 seniors occupy acute care beds while awaiting placement in long term care. This is not good for the patients, staff, or the system!
Very few of these issues can be dealt with by government alone—the gap between those who deliver services and government policy makers is too large and has existed since the advent of Medicare. Government has neither the experience, training, or knowledge of issues at the level of service delivery sufficient to make the key improvements necessary.
Government needs to enable and empower those knowledgeable health and senior care leaders and get out of the way. The system has been waiting for leadership for a decade. The delays in follow up have transformed the excitement and enthusiasm generated by the Aging Council report to suspicion and mistrust…..as one said, “oh, here we go again.”
Not only do seniors deserve better, the wonderful professionals and support staff who do some challenging jobs every day deserve better focus, direction and leadership.
Ken McGeorge is a healthcare consultant who has served as CEO of the Dr. Everett Chalmers Hospital, Region 3 Hospital Corporation, Halifax Infirmary, Kingston General Hospital, and the York Care Centre. He is the Vice-Chair of the New Brunswick Coalition of Concerned Citizens.