Current long term care system for elderly
Provinces are responsible for providing healthcare services (including LTC) to their residents. The Federal Government contributes some money to the provinces to support healthcare but health careis a provincial responsibility within certain national principles.
Program and nature of coverage
LTC is offered through both home care and community based care and is provided mainly by nursing homes across regions. Nursing homes can be both public and privately operated. The trend is to provide more community based care (sometimes called Home First) rather than through institutions. There are also residential care facilities available in Canada.
Nature of benefit coverage
Benefits under the system are administered by nursing homes. Individual assessment determines extent of coverage for individuals. It is important to note that benefit coverage can vary by jurisdiction.
Source of funding
Health service costs for medically necessary services are funded by general revenues generated through taxes. Some provinces levy specific health premiums.1 However individuals can be expected to contribute through co-payments, that vary by province, type of service and income level.
Reforms initiated/ future direction
The Canadian government relies on a multi level alloction of budget to control prices. Physicians are largely private practitioners paid on a fee for service basis. Provinces are looking at other payment mechanisms and in particular, linking payment to outcomes. Provinces are also developing and implementing a variety of new health system funding methodologies more closely tied to outcomes and not volume driven. In the case of LTC services, various co-payment mechanisms are being examined and implemented. There has been discussion about the need for a national pharmacare strategy. Every government is also moving ahead with efforts to improve accountability, transparency and healthy competition through public reporting.2
1Canada Long-term care (PDF 84 KB), 18 May 2011
Accessed 25 February, 2013
2Managed care keeping the frail out of nursing homes, New York Times, 2012
Accessed 1 June 2012.