20 Oct 2020 Fully public long-term care is not ideal elder care
by Anna Nienhuis
A BC NDP government will move to an entirely public system of senior care if elected, leader John Horgan said. The British Columbia provincial election is coming up on October 24, and after the COVID-19 pandemic exposed many deficiencies in long-term care facilities, this is a key issue for all parties to address. As home care services improve and our senior population increases, people age at home for longer and so often require high levels of care when they enter long-term care. But is full government provision of that care the best answer?
In BC, close to two thirds of long-term care homes are run by either for-profit or non-profit organizations. The government fully funds only about 40% of these facilities. Shifting the whole province to a publicly-funded, non-profit model would not only cost taxpayers significantly more, it would also, and more importantly, dramatically impact choice in elder care.
Governments have an important role in ensuring that the means are available to care for our vulnerable elders. All care homes should be open to inspection and regulation to ensure that certain standards are met. Still, it is crucial that a government promotes the ability of older adults to choose the type of care they receive when they need a long-term care facility. It is not that the government should never provide long-term care services, but that they should also respect the efforts of other sectors to provide this service.
Public policy should enable a variety of elder care options to flourish, giving our elders the right to choose a home where they feel safe, valued and cared for, and where their beliefs are respected. Long-term care homes should never be penalized for holding to religious standards that forbid, for example, assisted suicide or euthanasia.
Horgan was clear that the transition to a fully public system would not happen overnight, but the idea itself is concerning and an over-reaction to issues in long-term care delivery. Full government intervention is not a solution that will benefit and respect our elders long term. Government-run facilities face criticism over inconsistent reporting requirements, lack of transparency with funds, lack of third-party financial audits, and wide variation between different home operators in different locations. Private facilities, on the other hand, both non-profit and for-profit, follow strict reporting requirements, engage in annual audits of their finances, and often provide value-based care that directly appeals to those who choose to live out their later years there.
When considering the best way forward for elder care, our leaders should be first considering our elders, as well as how they themselves would want to age. They should also be thankful to the non-profit groups that do excellent work in this area, caring for an aging population with love and intention. The focus in elder care should not be on efficiency, control, or maintenance, but purpose, choice, and meaning. This should include promoting the availability of a variety of long-term care options aligning with different cultural, religious, and moral values rather than trying to fit them into a single government-run box.
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