Don’t blame seniors for soaring health costs

Grim predictions that our rapidly aging society will act like a “grey tsunami” to overwhelm and bankrupt our health care system aren’t accurate, according to UVic’s Canada Research Chair in Social Gerontology Neena Chappell and Marcus Hollander, president of Victoria-based Hollander Analytical Services.

In a groundbreaking new paper, the health policy researchers state an aging population will have less of a negative cost impact than so often claimed, and the primary factors in increasing health care costs are increased service provision to people of all ages—including those who are relatively healthy—and technological developments such as the increasing costs of pharmaceuticals.

The paper, “An Evidence-Based Policy Prescription for an Aging Population,” recently published in HealthcarePapers, lays out a plan for a more cost-efficient healthcare system. Chappell and Hollander note there are significant opportunities for cost savings while maintaining quality care for seniors, and significant savings can be achieved through better organization and management of their health services.

“Increasing costs are not inevitable,” says Chappell. “In a more integrated system of care delivery, it is possible to both save money and increase the quality of care at the same time.” Leading health policy experts from across Canada contributed 11 commentaries in response to the lead paper by Chappell and Hollander, who also wrote a response to the commentaries. Taken together, these 13 papers, and the guest editorial by the Canadian Health Services Research Foundation, provide a unique insight into the issues faced by federal and provincial governments as they try to hold the line on costs while ensuring that seniors receive appropriate health care.

“Rather than current systems where services such as home care and nursing homes may be in separate organizations, an integrated system of care delivery would provide lower cost, seamless care for seniors across a wide range of health and supportive services,” says Chappell. Hollander adds, “One system including community services such as meals on wheels, non-professional supportive services, professional home care services, supportive housing, long-term care facilities and specialized geriatric assessment and treatment units in hospitals would also have one overall budget. Professional case managers would coordinate care and assess needs, develop customized care plans, and authorize access to any of the services in the integrated system. They would also coordinate care with other parts of the health system, such as hospitals.”

The authors note that budgets for long-term supportive care that allow people to remain in their homes have been frozen or reduced, often resulting in deteriorating health and a more rapid move to more expensive hospital or nursing home care. While some seniors do need some professional care, say the authors, often their needs can be addressed primarily by non-professional supportive care such as feeding, bathing and maintaining a clean living environment.

The paper also calls for reducing the debilitating effects of age discrimination; facilitating the development of healthy communities at the local level; evaluating promising preventive initiatives; and providing enhanced support to unpaid caregivers (family and friends) who actually provide most of the care for older persons. More info: www.longwoods.com/content/22246 and www.longwoods.com/content/22258