No grey health-care tsunami coming
Last year was not a great year for seniors in Canada. There seemed to be an increased propensity to blame Canada’s economic problems disproportionately on the costs of health care, and seniors seemed to be the villains, depending on the commentator.
There were media reports about the “problem” and what steps could be taken to change the course of seniors allegedly consuming economic resources.
I answered one interviewer by suggesting that we give everyone free cigarettes and encourage smoking so that by the time people reach 65, they would all keel over and die. That would save the government huge amounts of money for pensions and health care. The interviewer paused until it clicked that my comment was ironic. The benefits of health care and its miraculous impact on the longevity and well-being of our Canadian citizenry, including its seniors, were not acknowledged in the media.
Historian Michael Bliss suggested that we should make users of the health-care system pay more for services through the income-tax system, based on use. However, that would have a very modest effect, as any extra revenues would come from tax-based charges to income, which for most seniors levels off considerably as they grow older.
A TD Bank study done last year also blew the “tsunami” horn, and its predictions included the projection that by 2030, health care would make up 80 per cent of the total provincial budget, up from the current 46 per cent. This did not take into account medical progress that often alters costs. For example, during the 1950s polio epidemic, the number of hospitalized, polio-afflicted patients in iron lungs seemed to be growing exponentially. But within a few years, the disease was vanquished with a vaccine that virtually eliminated it and its associated costs.
Of the 10 ways to cut health-care spending in Ontario suggested by the TD study, some specifically affect seniors. These included scaling back the Ontario Drug Benefit for high-income seniors so that it focuses on seniors in need. The problem with this suggestion is that the number of high-income seniors is small, so the health-care budget savings would be minimal.
Another suggestion was to increase bulk purchases of drugs to get better prices, which is already being done. The suggestion to incorporate a health-care benefit tax into the income-tax structure may increase revenues, but it would not change health-care utilization, as most use is not discretionary.
Seniors do not use medical care nor take medications for fun. The suggestion to take bolder action to promote healthy lifestyles is important, but while healthy lifestyles decrease the risk of certain conditions, they do not confer immortality.
The good news for seniors and policy makers is that two recent studies suggest that the “grey tsunami” poised to overwhelm the health-care system may be exaggerated. These studies found that of all the factors affecting the costs of health care, the aging population ranked low on the list of cost-drivers.
It is hoped that when the data presented in these studies are considered, the focus will be redirected elsewhere, rather than looking at seniors as the convenient scapegoat on which to blame increasing health-care costs, which although a challenge are not insurmountable.
Dr. Michael Gordon is medical program director of palliative care at Baycrest and co-author with Bart Mindszenthy of Parenting Your Parents (Dundurn Press). His latest book, Moments that Matter: Cases in Ethical Eldercare, follows his previous book, Brooklyn Beginnings: A Geriatrician’s Odyssey. All can be researched at his website: http://www.drmichaelgordon.com