Healthcare matters for all Canadians, but despite the fact that we are living longer, healthier lives, it becomes increasingly important as we age. For CARP members, it is a top priority. That’s what Susan Eng, CARP VP of Advocacy told members of the Finance Committee on November 2nd, 2011 when she presented before the Standing Committee on Finance and Economic Development.
The subject of the Committee hearing was the implementation of Bill C-13: the Keeping Canada’s Economy and Jobs Growing Act <http://www.parl.gc.ca/HousePublications/Publication.aspx?Docid=5155334&file=4> . The Canadian health care system serves Canadians well for acute care but is not mandated to provide continuing care for those with chronic diseases. That responsibility falls to informal caregivers and the home care sector, which at best is a patchwork across the country.
CARP has long held that a National Caregiver Strategy is vital if we are to keep leveraging the $25 billion dollars of unpaid homecare labour that caregivers off-set from the formal health system. A national caregiver strategy should include financial support, workplace protection as well as integration with the formal healthcare system.
While it is true that the implementation of any of these policies would be very expensive, there are sound ethical as well as financial grounds for undertaking such costly social programs. On a financial basis, the social and economic benefits derived from any of these programs would far outweigh the costs. We know that caregiving responsibilities will only increase as the population ages – the alternative to helping caregivers is that they end up burned-out or forced to quit their job (and therefore exacerbate the looming labour shortage and brittle economic outlook). The public policy challenge is to provide enough public support and incentive to lever the continued contributions of family caregivers to ensure that Canadians are able to age in health and safety in their own homes as long as possible.
CARP advocates for big-picture policy solutions but sometimes in the process of advocacy a specific window of opportunity presents itself and it is more efficient to focus on a specific ask. CARP’s particular focus during this Committee hearing was on section 23 of Bill 13 which provides for a non-refundable caregiver tax credit. CARP is recommending that the tax credit be made refundable and increased in amount.
The vast majority of Canadians want to stay in their own homes as long as possible even if they have medical challenges. Not only does this improve their health outcomes but it keeps them among their family and friends – all of which adds to their quality of life.
This is good social and health policy but it is also good fiscal policy – a well integrated and successful home care strategy has the potential of diverting massive amounts of demand from the formal healthcare system. Home care is 40% to 75% less expensive than institutional care.
The Proposals: Here is What the Federal Parties Pledged During the Election
Federal Conservatives:
· Family Caregiver Tax Credit: a 15-per-cent non-refundable credit on an amount of $2,000 that will provide tax relief to caregivers of all types of infirm dependent relatives including, for the first time, spouses, common-law partners and minor children.
o It is estimated that over 500,000 caregivers will benefit from the Family Caregiver Tax Credit. This measure would apply for the 2012 and subsequent taxation years.
o It is estimated to reduce federal revenues by $40 million in 2011–12 and $160 million in 2012–13.
o Amounts to a maximum of $300 per year provided you have taxes to pay
Federal Liberals:
· Family Care Employment Insurance Benefit: A new six-month insurance benefit so that more Canadians can take time off work to care for gravely ill family members at home without having to quit their jobs.
o Lower eligibility requirements for family caregivers, changing the nature of the required doctor’s certificate.
o Will build more flexibility into the program by allowing the six months to be claimed in smaller blocks of time over a year-long period and allowing family members to share the six months to provide care.
o Cost $250M
o Will not increase EI premiums
o 30,000 family caregivers would benefit
· A new Family Care Tax Benefit: Modeled on the Child Tax Benefit, to help low and middle-income family caregivers who provide essential care to a family member at home.
o The new benefit would provide individuals with a tax-free monthly payments of $112, up to $1,350 per year.
o This new benefit will work like the Canada Child Tax Benefit, and will be available to all family caregivers with family incomes under $106,000 who produce a medical certificate affirming that their ill family member requires a significant amount of personal care and assistance with daily tasks.
o Families with sick children who meet the criteria will also qualify.
o would apply to an estimated 600,000 family caregivers each year at an annual cost of $750 million.
· Employment Insurance Compassionate Care Benefit: to permit family members to take up to six months leave from work to tend to relatives near the end of their lives, up from the current six weeks
Federal NDP
· Caregiver Benefit: modelled after the Child Tax Benefit, to assist low and middle-income families in tackling the costs of everyday needs while caring for elderly or dependant family members.
o Eligible family members will include children, spouses, parents and other family members, and will be able to receive up to $1,500 per year;
· Home Care: Establish a new designated federal home care transfer of funds to the provinces to guarantee a basic level of home care services to all Canadians wherever they live.
· Home Adaption for Seniors’ Independence Program: Double the funding for forgivable loans under the Home Adaption for Seniors’ Independence Program (HASIP) to help seniors remain in their own homes.
· Inter-generational Home Forgivable Loan Program: Will introduce an Inter-generational Home Forgivable Loan Program, modeled on a Manitoba Government initiative, to help up to 200,000 families a year retrofit their homes to create self-contained secondary residences for senior family members. Families will be eligible for a forgivable loan to cover 50 per cent of the costs of a renovation up to a maximum of $35,000.
· Long-term Care: Initiate a new designated federal long-term care transfer to begin addressing the shortage of quality care spaces across the country.
CARP Brings Your Voice to Parliament
“Not only is a comprehensive home care and caregiver support strategy good public policy, it also makes good political sense.” Susan informed the Committee.
CARP informed the politicians in attendance of the feedback we received from membership on this issue. Thanks to your participation in the CARP poll, we knew that you appreciated the attention given to the role of family caregivers in the recent federal and provincial elections.
CARP members appreciated the acknowledgment of family caregivers with the specific non-refundable tax credit proposed and now passed in the recent budget. However, they preferred the refundable tax credit or allowance proposed in other platforms.
In CARP Action Online’s late October poll, 50% of you thought that the best way to support caregivers was an income allowance [15%] or refundable tax credit [36%]; only 11% of you thought the non-refundable tax credit was best.
“A refundable tax credit in the amount set forth in the Budget would be welcomed by the 2.7 million Canadians now providing care to older loved ones. However, there should also be a focus on those providing heavy care – those who are likely reducing their work hours or quitting their jobs altogether to look after a loved one – either permanently or during an acute period. Such people would not benefit from a non-refundable tax credit unless they had other sources of taxable income. Not only should they receive a refundable tax credit but the amount needs to be increased well beyond the $300 resulting from the budget changes.” Added Susan.
By the Numbers
Susan pointed out that these measures need not break the bank, expenditures could be contained.
- Although there are 2.7 million caregivers over 45, only 25% of them provide heavy care (defined as 30 hours or more of care per week). This reduces the number of caregivers who would receive support to 675, 000. A modest $1,500 per year for 675,000 caregivers would cost $ 1 billion a year. While this may seem like a lot of money, it would actually SAVE the government money. Other models exist to further reduce this cost. In Manitoba where there is a refundable caregiver tax credit of $1, 275 – the credit is means and need tested. The same applies in Nova Scotia (where after meeting the initial need and means test, caregivers also receive a different allowance of up to $400 according to need and means). Thanks to these cost containment measures, the Nova Scotia caregiver allowance only costs the provincial government $1.8 MILLION dollars per year.
- The value of the unpaid labour now provided by family caregivers is estimated to be $25 billion a year.
- They provide 70% of the community based care for seniors for study after studies show that many caregivers low-income caregivers are eventually forced to transfer their friend or family members to a publicly subsidized LTC facility because they cannot afford to subsist and are not able to work while providing the amount of care required to keep their charge at home.
- Home care is 40% to 75% less expensive than institutional care.
- Professional home care for someone needing moderate care costs $6, 496 per year while institutional care costs $17, 376 dollars per year. If the government paid for professional home care for 675, 000 people needing moderate care at home rather than in an institution this alone would save the government 10.8 BILLION dollars per year.
- Just imagine how much we would save by enabling family caregivers to care for their family members at home.
