US Private Insurance Vs. Canadian National Health Plan
Canada’s National Health Plan guarantees healthcare as a basic right for everyone, but since one of the cost-saving aspects of this plan is consolidation of medical resources into regional service providers, many elderly must travel to receive care. (Himmelstein) This is especially problematic for seniors that require long term care. Some seniors may have to travel many long hours away from their homes to access care, and since many of these seniors need assistance when traveling, there is often an increased strain on the friends or family who must accompany them. Long distance long term care can also limit the family’s ability to visit and help care for their elderly relatives. Although the U.S. is said to have an overabundance of available medical facilities (often with many duplicate facilities in close proximity to each other) this does not mean that seniors necessarily have more access to it. Multiple facilities cost more than one centralized facility and thus increase the cost of using them, rendering many seniors unable to pay for their medical care. (Himmelstein)
Current statistics of spending in Canada’s National Health Plan (NHP) show that senior care accounts for half of the plan’s total budget. (O’Malley) With the rising cost of healthcare coupled with the expanding population of the elderly, this percent of the budget is bound to rise as well. Additionally, as the elderly population is growing, the younger population that provides the majority of tax funding to the NHP is shrinking. This means that Canada’s NHP could face financial troubles in the future as their costs increase and funding decreases. Similarly, the American Social Security, Medicare and Medicaid systems are facing financial difficulties. When these systems were put in place, most seniors only lived long enough to use their benefits for a few years. Today, however, many seniors use their benefits for decades which leads to an increased strain on funding. Like Canada, as the elderly population in the U.S. continues to grow, those younger populations that pay into Social Security and Medicare are shrinking and so are the funds obtained from them. This paired with rising costs of care have already begun to cripple these systems. In fact, some hospitals and clinics refuse to admit elderly patients that use Medicare or Medicaid because these two government programs do not pay as much for services as private insurance. (Gorman)
Providing long term care for the elderly has become a major issue in both countries. The monetary cost of institutionalized long term care is often very expensive, and the emotional and psychological costs of long term care in the home are also very high. (O’Malley) Three traditional options exist for long term care: nursing homes, assisted living, and in home care. However, today’s seniors are more savvy than their predecessors and are coming up with new forms of long term care such as retirement communities that often include on site medical facilities. As large families that traditionally cared for elder members of the family have become smaller and less able to care for the elderly, seniors are looking for new forms of care such as these retirement communities. Nursing homes are the least used of the three traditional options, primarily because most seniors prefer a more independent lifestyle in their own homes. Assisted living is becoming a more popular option whereby a caregiver lives part or full time with the ill senior. Most seniors, however continue to live at home with unpaid family members giving them care. (O’Malley) This could be due to the high costs of institutionalized care, but it is more likely that seniors prefer to be with their families at home during their final years.
This preference for home care has led to a whole slew of problems in both Canada and the United States. Lawsuits against in-home providers are particularly problematic. These lawsuits have increased the cost of in-home providers due to and increased amount of malpractice insurance. Additionally, government agencies that provide in-home care services are losing desperately needed funds to lawsuits. (Arnold) Many of these lawsuits deal with another difficult problem, elder abuse. Since in-home healthcare providers are often unsupervised, elder abuse is difficult to control. Caring for a sick senior is a difficult task and can be emotionally frustrating, draining and enraging. All three of these emotions can lead to outbursts of elder abuse (not to say that everyone that experiences these feelings abuse their elderly charges). Often, in-home care providers need rest periods that are not available to deal with these feelings. (Arnold) Friends and family are extremely important for those caring for an ill relative, but feelings of guilt or geographical separation often stop caregivers from asking for help. Human social service offices, such as Georgiana Arnold’s office in Seattle, work to provide rest periods and other assistance to in-home care providers, but often even their help is not enough to alleviate stress and emotional pressure. (Arnold)
In Canada, with the NHP in place, paying for care is relatively easy for the elderly, but in the United States, there are a rising number of senior citizens that lack insurance or do not have enough coverage to pay for necessary medical procedures. (Himmelstein) In addition to being under-insured, seniors are facing the fact that many hospitals, insurance companies and government agencies are changing their qualifying factors for emergencies and other procedures that limit what their insurance will cover. Combined with the dwindling resources of Social Security and Medicare, poor seniors are faced with many challenges in paying for healthcare.
The aged homeless and poor mentally ill present a particularly challenging problem to the healthcare systems of the United States and Canada. In the US, these two groups do not have the necessary funds to pay for healthcare. While there are government and charitable agencies to help, the ill must come to them and often do not know that help is available. It seems that while these agencies are doing their best to help, much more effort is required to provide quality service to these two groups. On the other hand, Canada’s NHP guarantees healthcare for all, but a card must be presented to receive care. The aged homeless often do not have the resources (such as a mailing address) to obtain the NHP card and cannot get care. The mentally ill suffer similar consequences and may not have their card or may not have the mental faculties to use it. These two groups make it difficult for the government to step in and help, often due to their vagrant nature and difficulties in getting statistics on their status.
While the U.S. and Canada have vastly different systems of healthcare, each country faces changing problems concerning the health of their elderly populations. Government funded programs that pay for senior’s healthcare are finding that, with more seniors living longer, costs are rising at a previously unprecedented rate. In both countries, the elderly are facing new difficulties in receiving quality healthcare. In Canada, difficulty in accessing regional facilities and finding trustworthy long term care are two key issues for seniors. American seniors also face challenges in finding reliable long term care. The main concern of American seniors is paying for care, either through dwindling government funds or through costly private insurance. Both countries require real healthcare reform in order to meet the new challenges presented by the fast growing elderly populations of North America.
