Society's most vulnerable denied needed care

Groundbreaking new study exposes the impact of federal and BC cuts to community-based health care
November 9, 2000

(Vancouver) The BC Office of the Canadian Centre for Policy Alternatives co-published a major new study today. Without Foundation: How Medicare is Undermined by Gaps and Privatization in Community and Continuing Care finds that access to community and continuing care in BC has been seriously eroded over the past decade. Without Foundation is co-authored by Donna Vogel, Michael Rachlis and Nancy Pollak.

Community and Continuing Care (CCC) includes long term care, home nursing, and home support. CCC is supposed to be the foundation of a comprehensive health care system, yet much of the sector falls outside Medicare and national standards are nowhere to be seen. In the recent health accord with the provinces, the federal government abandoned its promise of a national home care program; yet today's study shows clearly that a national public and non-profit home care program is desperately needed.

"In 1991, BC's Seaton Commission called for a transfer of health care resources from hospitals to the community. But the sad reality of the past decade has been hospital downsizing with no parallel investment in community-based care." said Donna Vogel, one of the study's authors.

Cuts to CCC mean less access and higher private costs. In long term residential care, home nursing and home support, patients needing the lowest levels of care have been all but shut out of the public system. Rising private out-of-pocket costs, including drug costs, add even more barriers to accessible, quality CCC. "Community and Continuing Care has become more difficult to access over the past 10 years. The number of people receiving home support has actually fallen and thousands of seniors are on waiting lists for long term care," says Vogel.

Cuts to CCC cause undue suffering for some of BC's most vulnerable citizens--low-income women, people with disabilities and seniors living in poverty. The cutbacks also place an unsustainable burden on family members and care providers.

"For many people, home support is the difference between bearable and unbearable, healthy and unhealthy. For all of us, home support is supposed to be a preventative service that helps vulnerable people stay healthy in their home and involved in their community," said Nancy Pollak, another of the study's authors. "Home support should be an essential component of our health care system. Yet despite the hard work and commitment of staff, home support has become a restrictive, unfair and risky," says Pollak.

The gaps in CCC also create opportunities for private corporations to enter the health services "market." Mounting privatization in CCC will increase the cost of public health care over the long term. "An increasingly two-tier community care sector is a threat to Medicare," says Michael Rachlis, the third author of the report. "International research on the subject is clear. Compared with for-profit care, public and non-profit care is more efficient, less costly, and of greater or equal quality," he said.

The study calls on the federal government to immediately pursue cost-sharing arrangements with the provinces to bring all CCC programs and services under the public health care system. The government of BC should also reinvest in public and non-profit CCC services and infrastructure. Finally, the report calls for more research into the implications of increased privatization of community and continuing care.