Health Care for the Elderly in Canada

This article, written with American readers in mind, contains a number of comparisons of health data between the two countries—demographic and epidemiological, health care resources and expenditures. Although Canada sustains a much higher rate of institutional care (both acute and chronic) for the elderly than the United States, and has about the same level of availability of physicians, it expends considerably less per capita and as a percentage of the GNP or GDP. Part of the answer may be found in the much lower proportion of funding in the private sector in Canada. Federal funding for long term care has been provided not only through Canada's national hospital and medical insurance schemes but also in its Extended Health Care Services Program and Canada Assistance Plan. Provincial developments include a rapidly increasing variety of long term care services (both institutional and community) and much more readily available long term care insurance. This is occurring in all parts of the country though at different rates. A recently completed key informant survey emphasized the following issues: interprofessional rivalry and competition between the medical and social models; excessive institutionalization and medicalization; lack of interest in prevention of disease in the elderly; and cost constraints. The importance of housing, income and support for caregivers was also emphasized.