The federal government announced last week it will give the provinces and territories an additional $1-billion to help them keep their long-term care residents safe during this wave of the coronavirus pandemic.
One billion is a lot of loonies, even in these inflated times, but there was no scramble among the 13 premiers to express their gratitude to Prime Minister Justin Trudeau and his Minister of Just About Everything, Chrystia Freeland, for their generosity with the public purse. That’s not way it works in federalism, Canadian style.
Canadian federalism follows a time-worn path. The provinces complain Ottawa is not doing enough about something. They ask for more money. They accept the money. They protest that the feds are invading their constitutional jurisdiction. They ask for more money.
It was ever thus and will be again on Thursday when the Prime Minister and the premiers meet for another of their virtual conferences on the pandemic. In addition to more money right now, the premiers will be asking for a larger, permanent share of the nation’s wealth through the transfer of federal tax resources to enable the provinces to carry their load in the health field.
Although they won’t get Ottawa to commit to anything permanent, they will come away with greater pandemic support until COVID-19 vaccines arrive and are distributed. They need every cent they can get. The pandemic has imposed a crushing financial burden on both levels, but especially on the provinces, which don’t have Ottawa’s tax tools or borrowing capacity. Some are in truly desperate shape.
Even wealthy Alberta is party to the provincial plight. Thanks to the gross mismanagement of United Conservative Premier Jason Kenney – who kept insisting that Albertans had the Charter right to ignore such public safety precautions as masks and social distancing, and to continue to do any damn fool thing they wished – the piper has come to be paid. The province now has the highest rate of active COVID cases in Canada and an alarming death rate. And Kenney now is reduced to asking Ottawa to please send him field hospitals to handle the surge of infections among Albertans who, embracing his be-free, have-fun doctrine, had seen no need to avoid crowded bars, indoor receptions and mass public gatherings.
Looking down the road, what is the country going to do about the “terrible tragedy,” as Justin Trudeau described it on Friday, of long-term care homes? They accounted for 80 per cent of the deaths in the pandemic’s first wave are tracking in the same deadly direction in the second wave.
Money alone will not do it, because there will never be enough money. The $1-billion Safe Long-Term Care Fund that Ottawa announced last week may help in the short term, but it does not address what Don Drummond, a former federal associate deputy minister of Finance and chief economist at TD Bank, calls the demographic “tsunami” that is threatening to overwhelm the LTC system.
Now a professor at Queen’s University, Drummond is one of three authors of a report, “Ageing Well,” published by the university in late November. The report found that Canada lags badly behind other developed countries in investing in the care of the elderly, with a ratio of 3.5 LTC workers per 100 seniors, compared to an OECD average of 8.2.
Seniors account for 17.5 per cent of Canada’s population today, a figure projected to rise to 25 per cent in the next 20 years. This means an increase of four million seniors. Just keeping pace with the increase would require a near-doubling of long-term care beds by 2041 – meaning 250,000 new beds.
The trend, however, is in the wrong direction. In 2018, Ontario Premier Doug Ford promised to create 15,000 new LTC beds within five years; in July this year, he lowered the target to 8,000 beds. But even 15,000 additional beds would clear less than half of the current patient backlog in Ontario.
The answer, to the extent there is one, is to keep elderly Canadians out of long-term care for as long as humanly possible. As the Queen’s report notes, “The argument that Canada needs primarily to expand the capacity of LTC homes misses the mark on several points. It is based on the current policy of ‘warehousing’ seniors … Rather, the problem is a paucity of alternatives from which seniors can choose, coupled with chronic underfunding of preferred alternatives such as home care and community services.”
Money is important, but safety matters more. “Preferred alternatives” would not come cheap. They would not save money. But they would surely be safer than warehousing.
Cambridge resident Geoffrey Stevens, an author and former Ottawa columnist and managing editor of the Globe and Mail, teaches political science at the University of Guelph. His column appears Mondays. He welcomes comments at [email protected]