Long term care

If multi-tier, privatized health care is wrong for Albertans, why is it right for Alberta seniors?

Premier Alison Redford clearly knows how urgently Alberta needs more nursing home beds. But her idea that the way to get them is to remove the current ceiling on accommodation rates at these facilities is misguided and unfair.

The Premier’s stance is inconsistent with her strong opposition, during the PC leadership race, to Gary Mar’s suggestion that it is time to allow people with money to buy better, or faster, access to health care.

If multi-tier, privatized health care is wrong for Albertans, why is it right for Alberta seniors?

And make no mistake: nursing homes, or long-term care facilities as the government calls them, are not “seniors’ accommodation” like lodges or seniors’ apartments. They are health care facilities for people medically assessed as cognitively impaired and requiring 24/7 monitoring; or people who are chronically ill; or people who are profoundly frail to the point that they require help getting out of bed, toileting, bathing, dressing, and getting to the dining room.

As in hospitals, medical care is free in long-tern care facilities (i.e. nursing homes, auxiliary hospitals and designated assisted living), but residents are charged an accommodation fee for room and board.

Current rates are:

Accommodation	Daily rate	Monthly rate
Ward	$45.85	$1,395
Semi-private	$48.40	$1,472
Private	$55.90	$1,700

The government does subsidize these rates, but only for seniors whose annual income is below the very low- income threshold to qualify for the Alberta Seniors’ Benefit program ($24,600 for a single senior and $40,000 for couples).

Long-term care is the only category of health care facility for which room and board is charged.

Long-term care is also the only type of seniors’ care facility in which the government has regulated rates, and these accommodation rates have increased by about 90% in the last decade.

Accordingly, one has to ask why the government is talking about lifting ‘caps’ on these fees and abandoning the most vulnerable seniors to the tender mercies of the private-for-profit seniors’ care industry?

WHY?

The official rationale for lifting the ‘caps’ on these accommodation rates is that private developers will be motivated by profit to build the required nursing homes. If there is no limit on what they can charge, that may be true, but what about those low to middle income seniors who simply cannot afford $5,000 or more a month for a nursing home?

The real reason the government wants to lift the ‘caps’ is to off-load its health care costs – the same reason that has led to the current chronic shortage of nursing homes.

This shortage has led to many seniors being placed in inadequate assisted living facilities where the lack of qualified nursing staff means that residents are frequently sent off to the nearest ER for even minor medical conditions that a properly staffed nursing home could easily handle.

Recent figures report about 1,600 Alberta seniors who have been medically assessed as requiring long-term care are awaiting placement. Many of these are waiting in acute care hospital beds.

Hospital beds are not only one of the worst places for people with weak immune systems; they are also a ridiculously expensive way to care for seniors who need nursing care, not active treatment.

The government’s failure to provide LTC beds for Alberta’s most vulnerable seniors led to the situation where doctors were predicting the ‘imminent collapse’ of the emergency medicine system caused, in part, by seniors blocking acute care hospital beds.

RATIONALE

The rational put forward for lifting the ‘caps’ on LTC accommodation rates acknowledges that these are health care facilities, but points out that they are also people’s homes. It goes on to argue that people have a right to live in the type of home they can afford.

This rationale ignores the fact that there are already lots of private nursing homes for wealthy seniors. If they are wealthy enough, people can stay in their own home and hire a private, full-time nursing team.

The real problem is with low to middle-income seniors who don’t qualify for the Alberta Seniors Benefit, but who won’t be able to afford the accommodation fees in privately built and operated nursing homes.

The Problem

These low to middle-income Alberta seniors who require nursing home care paid taxes and health care premiums throughout their working lives. They built a UNIVERSAL health care system that was supposed to provide medically necessary services on the basis of need, not ability to pay, and they thought it would be there for them when they needed it.

The Solution

Simply provide enough publicly built and operated nursing homes to meet the need and relieve the pressure on the public health care system.

Accordingly, it is not surprising that frail seniors feel betrayed by ageist government policy that segregates seniors as the target group to be exempt from universal coverage in order to reduce the cost of health care in the province.

The reason for lifting the ‘caps’ on nursing home accommodation is not to reduce the cost of such care, but rather to saddle seniors with the additional cost of profit for investor-owned corporations.

Even those seniors who have availed themselves of LTC insurance will be negatively affected because such plans only cover a maximum daily accommodation rate that may not be sufficient to cover nursing home rates in the future.

The Threat

If the government is successful in transferring its responsibility to provide seniors health care facilities on to the private sector, and off-loading the cost onto those who require the care, how long will our public health care system survive?

Produced by

S.A.L.T.

The Seniors Action and Liaison Team

(www.saltalberta.blogspot.com)