The idea was one of 169 recommendations contained in a report, Living Longer, Living Well presented to Matthews. It is designed in part to reduce the skyrocketing health care costs for seniors, who account for about 50 per cent of the what the province spends on health care.
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The 198-page report by Dr. Samir Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals, recommended the Health Ministry explore an income-based system for home care and community support services.
“I think it is time for us to have that conversation. We have moved to that on drugs for example in the last budget,” Matthews said, adding later that “nobody got too excited about it because they know we have got to do things a bit differently.”
Starting in August 2014, for seniors 65 years and older with an income of more than $100,000, the deductible for drugs is $100 plus three per cent of net income over $100,000, while for senior couples with a combined income of more than $160,000, the deductible is $200 plus three per cent of their family net income over $160,000.
Matthews told the Star, for example, there already is a user fee for Meals on Wheels.
“We are not the first province to think about it. In fact we are one of the last provinces to think about it. It’s a recommendations and I think it’s one that merits some thinking. But the bottom line is it would only apply to people who had the means to afford it,” she said.
The Sinha report was commissioned as part of the province’s Seniors Strategy announced a year ago.
MPP France Gelinas, the NDP’s health critic, said the user fee recommendation will raise red flag because “we see that as a barrier to access.”
Matthews said of the many recommendations the province is keenest on matching every senior with a primary care provider, be it a doctor of nurse practitioner who see that they get the continuum of care they need.
“The question is how can we afford not to do it because it actually costs the system a lot more when people aren’t attached to primary care providers,” she said.
Sinha told a news conference the older population in Ontario is going to double in the next 20 years, “and currently they account for 50 per cent of our health care spending. If we do nothing different … then we are going to be in trouble.”
He said for example “we need to triple the number of long-term care beds in our province” over the next 20 years while emphasizing the need to keep seniors in their homes as long as possible through improved home care and wellness programs.
Susan Eng, of the senior advocacy group CARP, said all the recommendations hold promise and called on the province to get busy implementing them.
“The single greatest concern for our members has been health care and access to health care,” Eng, vice-president of advocacy for CARP.