SOC246H1 Lecture Notes - Erving Goffman, Commodification, Total Institution

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5 Apr 2012
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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
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-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), 2nd 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)
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