Home care is not covered by the Canada Health Act and so there is no guarantee that medically necessary services be covered by public insurance. This lack has long been one of the concerns raised by advocates of public health care, especially as home care plays a bigger role in health care.
Conference Board of Canada figures (released with a study yesterday) heighten this concern, at least for Ontario, where the role of private payment is increasing. Conference Board estimates indicate that the increase in public funding for home care in Ontario (in nominal dollars) was between 62% and 65% over the 11 years from 1999 to 2010. Over the same period, private payment for health care increased 88%. That is over one-third faster.
Canada-wide the story is a little different. There, home care spending increased much more rapidly, both in the public and private spheres, with increases -- in both spheres -- in the 100% range.
Ontario lost a lot of ground in publicly funded home health care during the last Progressive Conservative government. While other provinces moved ahead during this period, Ontario actually decreased funding. In the publicly funded home support category, Ontario continued to increase funding during that period, but still fell well short of the Canada-wide increase.
According to Conference Board figures, home care fell as a percentage of total health care spending, falling from 5.82% in Ontario in 1999 to 4.65% in 2010 (and from 4.72% to 4.54% Canada-wide). Again, in Ontario all of the decrease was during the Progressive Conservative years; there has been a small rebound during the Liberal years (from 4.51% to 4.65%).
In Ontario, home support service funding has increased more rapidly than for home care services. Judging by the recent government announcement to modestly increase Personal Support hours (and its deathly silence on home health care services which have been squeezed hard in recent years) this trend continues.
In Ontario, home support service funding has increased more rapidly than for home care services. Judging by the recent government announcement to modestly increase Personal Support hours (and its deathly silence on home health care services which have been squeezed hard in recent years) this trend continues.
Ontario
|
Canada
|
||||
Public Pay
|
|||||
Home Health
|
|||||
High Est.
|
Low Est.
|
High Est.
|
Low Est.
|
||
1999
|
1048972
|
670015
|
1933000
|
1234675
|
|
2010
|
1655130
|
981402
|
3963091
|
2349898
|
|
% increase
|
58%
|
46%
|
105%
|
90%
|
|
Home Support
|
|||||
1999
|
699339
|
699339
|
1578534
|
1578534
|
|
2010
|
1232670
|
1232670
|
3225621
|
3225621
|
|
% increase
|
76%
|
76%
|
104%
|
104%
|
|
Total Public
|
|||||
1999 Total
|
1748311
|
1369354
|
3511534
|
2813209
|
|
2010 Total
|
2887800
|
2214072
|
7188712
|
5575519
|
|
% increase
|
65%
|
62%
|
105%
|
98%
|
|
Private Pay
|
|||||
Home Health
|
|||||
1999
|
3358
|
3358
|
8000
|
8000
|
|
2010
|
9819
|
9819
|
25355
|
25355
|
|
% increase
|
192%
|
192%
|
217%
|
217%
|
|
Home Support
|
|||||
1999
|
307850
|
307850
|
733485
|
733485
|
|
2010
|
574935
|
574935
|
1484593
|
1484593
|
|
% increase
|
87%
|
87%
|
102%
|
102%
|
|
Total Private
|
|||||
Total 1999
|
311208
|
311208
|
741485
|
741485
|
|
Total 2010
|
584754
|
584754
|
1509948
|
1509948
|
|
% increase
|
88%
|
88%
|
104%
|
104%
|
All numbers are in thousands of dollars.
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