Publicly funded home care appeals to Ontario voters and politicians

It has long been obvious that, when Ontario’s political leaders hit the hustings this fall, none of them will be eager to discuss with voters the difficult questions about how to make the public health system sustainable.
But there’s some hope that, if nothing else, the coming campaign will move the province toward taking a necessary (if relatively easy) step toward bracing the system for the onslaught of an aging population.
The expansion of publicly funded home care is a rare sort of sweet spot – a policy that has the potential to win votes for politicians while actually saving governments money down the road. To a great many people, there is considerable appeal in giving themselves, their parents or their grandparents the opportunity to be cared for in their later years in the comfort of their own homes, rather than in hospitals. And for governments, that option has the potential to help clear up one of the biggest drivers of health-care costs – the so-called “bed blockers” who tie up roughly 20 per cent of hospital beds, even though they could be treated elsewhere.
This appears not to have been entirely lost on any of the provincial parties. The Progressive Conservatives promise, albeit rather vaguely, that they would set up “a new government-funded home care provider.” The New Democrats pledge that they would deliver an additional million hours of home-care services each year. And sources say that the Liberals, who have made rather limited progress on home care during their eight years in office, are nevertheless considering making it a big part of their re-election platform.
If so, there’s plenty of room for Dalton McGuinty’s government to go above and beyond what’s currently on the table. While the NDP’s promise seems the most ambitious so far, it would represent just a 3-per-cent increase over existing home-care service – enough perhaps to help with current demand, but not to prepare for what’s coming. (Questionably, Andrea Horwath’s party claims it could do this while taking $65-million out of the $1.9-billion Ontario spends on home care each year by finding administrative savings.)
Although all the parties are reluctant to make major new spending commitments given the province’s $16.7-billion deficit, an argument could be made that there’s some awfully good value here in the long run. The average annual cost per home-care client, according to the provincial Health Minister, is $3,956.76. That amount covers less than a week of chronic in-patient care in a hospital, and less than a month for the average patient in a long-term care facility.
Of course, it’s not as simple as just writing a bigger cheque. Most everyone concedes that the home-care system, administered mostly through the province’s 14 Community Care Access Centres, is unwieldy. Establishing a more efficient delivery system, which both opposition parties are hinting at, would have to be part of the equation.
But then, there are very few easy ways to modernize health care. And this one, unlike many others, can at least be sold as making patients’ lives more pleasant – all while freeing up hospitals to focus their attention on acute care.
Mr. McGuinty’s Liberals, who face an uphill battle to get re-elected, may well have lost their chance to really move this issue forward themselves. But as they cast about for a good reason to ask for a third mandate, this seems like a good place to start. And though this surely isn’t their priority, using their platform to raise the home-care bar could at least compel the opposition parties – including the Tories, who lead in the polls and promise more details on their home-care plans closer to the election – to be more ambitious.
As a general rule, games of one-upmanship before elections can have unpleasant consequences after them. But a bidding war over home care might be the best-case scenario for moving the health system forward during the coming campaign.
Source http://www.theglobeandmail.com/