Tuesday, September 02, 2003

Liberals' new care rates for seniors fair
By Paul Willcocks
VICTORIA - The Liberals' implementation might be a little harsh, but there's nothing wrong with their plan to increase the cost for seniors in residential care.
Not everyone sees it that way. Some seniors organizations have reacted angrily to fee increases that will hit more than 7,000 people in long-term care, dinging them for an average increase of $2,360 a year.
About 1,000 people at the top end of the income scale will see their costs jump by 30 per cent. The accommodation, board and care that have been costing $1,520 a month will suddenly jump to almost $2,000.
That is too big a jump, even given the five-month notice the government has provided. It would have been fairer to cap the increases at 10 per cent, and phase them in. Few of us could cope with a 30-per-cent increase in our living costs, at a time when our income is fixed. (Though fees haven't increased since 1997.)
But the basic principle behind the increase is sound, and the new rates don't seem unfair.
About 25,000 people live in government-supported residential care facilities, which provide more support than an assisted-care facility and less than a hospital. They pay a fee based on their income, and get 24-hour nursing care, room, board and recreational programs.
About three-quarters of them won't face any increase. People with gross income under $18,000 pay $825 now, and most have very little left over for any other expenses. They won't pay more until 2004, when the government plans to start levying annual hikes based on the consumer price index.
Everyone else faces increases.
Residents pay on a sliding scale. The higher your gross income, the higher your monthly bill.
For all residents, the rates represent a pretty good deal. People pay between $825 and $1,975 a month. But the government estimates the cost of providing residential care at $4,500 a month. Taxpayers - some facing their own tough times - are already subsidizing the cost. (That $4,500 cost isn't inflated. Ask any family that despaired of long waiting lists and had to go out and find a private facility for an aged relative.)
The taxpayer subsidy is money well-spent. Affordable residential care doesn't just mean a better quality of life. Helping people live with lower levels of support is far more cost-effective than the alternative, which too often ends up being much more costly acute care.
Is the government charging too much? Someone with $12,000 a year in income pays $825 a month for food, shelter and care. That's more than 80 per cent of their income, but it still leaves about $175 a month for other expenses.
At $25,000, a resident would pay $1,080 a month, about half their income, leaving about $1.000 or other monthly expenses.
And at $65,000, a resident would pay a little over one-third of his income - about $1,975 - and have $3,430 for other expenses.
It's easier to make the case that some residents should be paying more than it is to be critical of the government's direction.
Seniors' irritation is understandable. The Liberals have pushed their cost of living up sharply, reducing Pharmacare benefits and hiking MSP premiums. For those in residential carte, this is another aggressive hit, one that should have been phased in.
And the government should have announced that the $17 million from the increases would be used to used to open new residential care beds. The money is enough to cover the operating cost for about 400; the announcement would have shown that the increases aren't just a cash grab. (To be credible the announcement would have to specify places and communities, instead of offering vague platitudes.)
But those are questions of implementation.
The principle, that people who receive benefits should pay for them, at a fair price that is within their means, is reasonable. The new rates don't appear to place an excessive demand on residents. They are fair.

No comments: