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Policy, Payment, and Participation: Long-Term Care Reform in Ontario

Published online by Cambridge University Press:  29 November 2010

Raisa B. Deber  and
A. Paul Williams
Raisa B. Deber
Affiliation:
University of Toronto
A. Paul Williams
Affiliation:
University of Toronto
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Abstract

Although Canadian Medicare gives the population “reasonable” access” to all “medically necessary” physician and hospital services, long-term care is not formally subject to those conditions. In Ontario, long-term care involves a “patchwork quilt” of government, charitable, for-profit, and personally-provided services; an ongoing consultation has been under way in an attempt to rationalize service financing and provision. This paper reviews the series of policy proposals and the accompanying public consultation processes. It concludes that the emphasis on “community involvement” without a clear definition of “community” or the goals of participation has paradoxically increased the “scope of conflict,” increased frustration among stakeholders, and made policy action more difficult.

Résumé

Bien que le programme d'assurance-maladie canadien assure à la population un «accès raisonnable» à des services médicaux et hospitaliers «nécessaires au point de vue médical,» les soins de longue durée ne font pas officiellement partie de ces modalités. En Ontario, les soins de longue durée consistent en un amalgame de services offerts par le gouvernement, des organismes de charité, des organismes à but lucratif et des particuliers. Une consultation continue a été entreprise afin de rationaliser le financement et la prestation des services. Cet article passe en revue la série de propositions de politiques présentées et le processus de consultation auprès du public s'y rattachant. Les auteurs concluent que l'accent mis sur la «participation communautaire» sans une définition claire du concept «communautaire» ou des objectifs de la participation a contribué paradoxalement à élargir «l'ampleur du conflit,» à frustrer davantage les intervenants et à faire obstacle à la mise en oeuvre de politiques.

Keywords

Long-term CareHealth ServicesHealth PolicyFinancingConsumer Participation.Soins de longue duréeservices de santépolitique de santéfinancementparticipation.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 14 , Issue 2 , Été/Summer 1995 , pp. 294 - 318
Copyright
Copyright © Canadian Association on Gerontology 1995

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