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March 21 2012.docx

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University of Toronto St. George
Markus Schafer

March 21, 2012 Soc204H1S Next week watch film (on exam) The CDN Pension System… -how well this 3 tier system does for older people -system improving over time (1980-2003, drop off of poverty rates in older ppl) -one of the best in the world; sustainable costs, successful in reducing rate of old age poverty Despite the success of the CDN pension system, poverty remains higher among…  Aboriginal CDNs  seniors w/ health problems  immigrants (have to live in Canada 10 yrs to be eligible for OAS/GIS + a reduction for shorter periods of time lived in Canada) – if lived 18-65 not continuous years (incremental penalty for not living here continuously as an adult)  those living alone  women (older women, living alone at risk of being in poverty)-feminization of poverty in older age Conclusion Old-age security reflects an implicit social contract in the modern welfare state, but it also involves a more specific intergenerational contract. ~implicit agreement/no absolute guarantee that money will be there when you turn that age  Common concern: do older adults receive disproportionately high benefits relative to others?~fair share? Intergenerational inequity  “Age integration vs. age conflict” – Anne Foner’s 2000 essay, The Gerontologist; i.e. poverty among children, university students’ debt, health care costs – graph 1999 & 2005 net worth minus debts/wealth of different age groups the largest increases in wealth are mostly at the high end of the age distribution in Canada (45-64, 65+ ~$350, 000 26% jump) – will intergenerational solidarity stay or fray (state/gov’t)? Or will the balance shift to individual responsibility (old age financial security)? Care for Older Adults -as ppl age, they often time need help (premise) i.e. medical issues (managing chronic illness), shopping, personal care, chores, housework, meal prep, transportation 1. Informal care from family & civil society-most care ppl receive are from informal institutions (family members), public service complement not replace family care -20% adult pop. In n. America provide unpaid help to older person needing help -most common caregiver: person’s partner (if they have one), 2 offspring – based on availability in their social network = demographic availability* -60% ppl offering care to older person = females (daughters for aging parents ^) ~ real gender inequity Caregiver “Squeeze”? newer demographic trends: a. Longer life spans b. Smaller family size (beanpole family) c. More dual-income & households w/ divorces 2. Health care system In Canada, multiple provincial & territorial systems (series of different health systems) – matter of jurisdiction/province (details of administration of healthcare) -efforts to standardize across provinces though; start w/ Saskatchewan w/ Public Health Care -federal gov’t pledge half of costs to provide universal public health care Canada Health Care Act of 1984: federal government reaffirms its commitment to standardized health care for all 5 key principles: universality, public administration, comprehensiveness, portability & accessibility Restricted to “medically necessary hospital, physician & surgical-dental services”; leaves all elements of care unregulated to the federal level Several gaps & Challenges: 1. prescription drugs (expected to be too expensive to maintain); important part of health care needs of many older ppl; wide variation by province about how prescription drugs are managed i.e. Manitoba Saskatchewan, NFLD only low income senior covered; Ontario, Quebec, Nova Scotia reimbursements proportional to cost & income level ex. Older man w/ average income & a $1280 prescription drug burden: would pay over $1200 in Manitoba but only $60 in New Brunswick 2. long-term care: broad range of services that encompass various things (i.e. skilled nursing care, assisted-living facilities, home care, hospice care) = long-term responses to chronic illnesses &disabilities that can take place in various places (community, homes, institutions); -shift away towards keeping ppl in community/homes & integrate them and away from institutions  more burden on informal care givers *with variation across provinces, and within the provinces themselves (most seniors fall b/w gaps b/c of long & complicated process; about 4/10 trouble w/ mobility don’t regularly have adequate help to get around) *institutionalization vs. individualized health-service needs met at home (shifts emphasis, subtle blend w/ medical & social/community care ~requires coordination between these actors (family, community & medical)) -CCAC community care access centers –coordinate network services; funding & sustainability concerns – Ontario-run, need federal gov’t to help costs so this type of program/center can be sustainable  Institutional long-term care -aging in home is goal but often time institutional living becomes the requirement Nursing Homes -most medical services for ppl, short-term rehabilitation wings Assisted living facilities -response to nur
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