Wrest control of funding and priorities from services providers to focus on healthcare citizens: CARP Poll
FOR IMMEDIATE RELEASE
December 15, 2014
Toronto, ON: Seventy-five percent (75%) of CARP members call for transformative change in the health care system they say is not meeting their needs, too difficult to navigate and is not patient-centred despite jargon to the contrary. They also see direct medical care as only one of five pillars of health care that would more fully provide for the health and well-being of Canadians. [Poll report copied below]
Over 1,500 CARP members responded to a weekend poll on reform of the health care system and strongly support the reform imperatives contained in CARP’s submission to the federal Advisory Panel on Health Innovation which calls for a full system re-design to provide a comprehensive 360 degrees of care and that treats Canadians as “healthcare citizens” – with the right to expect timely and appropriate care and equal treatment regardless of age, income and postal code.
The CARP Poll™ results demonstrate that CARP members are deeply dissatisfied with the current healthcare system, something that continues to be a CARP advocacy priority:
- 79% find the system too difficult to navigate (27% feel this strongly)
- Virtually all think CARP’s five pillars are critical parts of the health care system:
o social determinants of health – 93%
o prevention of illness – 98%
o right medical treatment and care, when and where needed – 100%
o caregiver support – 97%
o end of life care – 99%
- 85% think the healthcare system needs to change and 35% want transformative change
- 50% do not think the healthcare system is fulfilling its mandate under the Canada Health Act to “improve and maintain the health and well-being of Canadians”
- 77% think the hospital and clinic focused system will have to breakdown its silos of practice, funding and cooperation to achieve the transformative change they want
“Healthcare is a priority for all Canadians and resonates particularly with older Canadians. CARP members are saying that the system is failing them badly and call for disruptive change to remove the silos that make the system difficult to navigate, to wrest control over priorities and budgets away from the service providers and re-focus on those they are meant to serve. They don’t want to be treated as just “patients” or “consumers” but as “citizens” entitled to the values set out in the Canada Health Act. They also offer specific measures based on their lived experience.
“We can expect push-back from those who have monopolized health care policy making to date and those engaged in jurisdictional squabbles but they’d be pushing back against a virtually unanimous group of the most politically engaged voters for whom this is unequivocal priority”, said Susan Eng, VP, Advocacy for CARP
Additional commentary on CARP’s submission may be found at: http://www.carp.ca/2014/12/08/healthcare-reform/
CARP is a national, non-partisan, non-profit organization committed to advocating for a New Vision of Aging for Canada, social change that will bring financial security, equitable access to health care and freedom from discrimination. CARP seeks to ensure that the marketplace serves the needs and expectations of our generation and provides value-added benefits, products and services to our members. Through our network of chapters across Canada, CARP is dedicated to building a sense of community and shared values among our members in support of CARP’s mission.
For further information, please contact:
Sarah Park 416.607.2471
Director, Communications
[email protected]
Michael Nicin 416.607.2479
Director of Policy
[email protected]
Anna Sotnykova 416.607.2475
Media & Communications Coordinator
[email protected]
CARP Health Focus Poll Report
December 15, 2014
Key Findings
There is wide agreement the health care system needs disruptive change to become patient-centred and sustainable, and there is virtually unanimous agreement that CARP’s five health care pillars; social determinants of health, prevention of disease, the right kind of care when and where it’s needed, caregiver support and end-of-life care, are fundamental to their health and well-being.
The vast majority of members call for fundamental changes to the health care system to properly fulfill its role in the health and well-being of Canadians, and reducing wait times, reducing the rate at which costs increase and making the system more patient-centred and less procedure oriented are seen to be the ways to do this.
The vast majority approve of CARP’s call for a more patient-centred system, three quarters agree the system is difficult to navigate and just one half agree that the health care system as constituted meets the principles laid out in the preamble to the Canada Health Act.
Virtually all members find CARP’s five pillars of health care reform (social determinants of health, prevention of disease, the right kind of care when and where it’s needed, caregiver support and end-of-life care) to be important to reforming the system.
Three quarters agree that the health care system will have to let go of many cherished privileges, protocols and customs in order to rebuild to sustainably fulfil its role in maintaining and improving the health and well-being of Canadians.
Detailed Findings
One half of members agree that many aspects of the health care system need to be improved for it to become sustainable, while a further third opt for the most transformative option, a complete redesign of the system (35%). Few think few changes (9%) or no change is needed (1%).
What must happen to the health care system in Canada to allow it to move sustainably into the future?
| Improve many aspects of current system | 51% |
| Fundamental redesign of health care delivery | 35% |
| Minor changes in health care system | 9% |
| NO CHANGE REQUIRED | 1% |
| OTHER/DON’T KNOW | 4% |
Wait times (29%) and the fast-increasing cost of health care (21%) are the aspects of the system most in need of attention, along with becoming a patient centred system, instead of procedure oriented (18%).
Which one aspect of the health care system in Canada is most in need of improvement?
| Reducing wait times | 29% |
| Reducing rising cost of health care | 21% |
| Making system centered on patients, not procedures | 18% |
| Pharmacare/high drug costs | 8% |
| Better palliative/end-of-life care | 7% |
| Difficulty navigating system | 6% |
| Impersonal attitude of health care system | 5% |
| Delivery of/access to chronic care | 4% |
| NO IMPROVEMENTS REQUIRED | * |
| OTHER/DON’T KNOW | 2% |
Virtually all members approve of CARP’s call for a more patient-centred, home-based health care system (95%), and one half approve strongly (51%).
CARP has called for a change in the way health care is delivered in Canada, placing a greater emphasis on patient-centred preventive and chronic care delivered at home or in the community. Do you approve or disapprove of this idea?
| APPROVE | 95% |
| Approve strongly | 51% |
| Approve | 44% |
| DISAPPROVE | 3% |
| Disapprove | 2% |
| Disapprove strongly | 1% |
| DON’T KNOW | 3% |
Most agree that older patients find the system hard to negotiate (79%), and about one quarter agree strongly (27%).
Do you agree or disagree that older Canadians and their families find the health care system is difficult to navigate?
| AGREE | 79% |
| Agree strongly | 27% |
| Agree | 52% |
| DISAGREE | 11% |
| Disagree | 10% |
| Disagree strongly | 1% |
| DON’T KNOW | 11% |
Half disagree the health care system fulfills the preamble to the Canada Health Act, promising equal and fair access to health care for all Canadians (50%),.
The preamble to the Canada Health Act states that “continued access to quality health care without financial or other barriers will be critical to maintaining and improving the health and well-being of Canadians”. Do you agree or disagree the current health system meets these principles?
| AGREE | 46% |
| Agree strongly | 11% |
| Agree | 35% |
| DISAGREE | 50% |
| Disagree | 37% |
| Disagree strongly | 13% |
| DON’T KNOW | 5% |
Members were asked to rate the importance of CARP’s five health care pillars; addressing the social determinants of health, prevention of disease, the right kind of care when and where it’s needed, caregiver support and end-of-life care.
Virtually all members think it important for the health care system to address socioeconomic inequalities in care delivery (93%), and 3-in-10 say it is “extremely important” (30%).
How important is it for the health care system in Canada to be designed to account for, and minimize socioeconomic inequalities in health care delivery?
| IMPORTANT | 93% |
| Extremely important | 30% |
| Very important | 45% |
| Somewhat important | 18% |
| NOT IMPORTANT | 5% |
| Not very important | 3% |
| Not at all important | 2% |
| DON’T KNOW | 2% |
The most important social determinant to address is poverty among some patients, including seniors, children and families (35%), followed by independent living for seniors (27%) and harm reduction in lifestyle behaviours (10%). One tenth think the system has no role in ameliorating socioeconomic inequalities (9%).
Which of the following socioeconomic factors is the most important for the health care system to address?
| Poverty/low income seniors/children/families | 35% |
| Ability of seniors to live independently | 27% |
| Reduction of harmful lifestyle behaviours | 10% |
| Social integration and engagement in community | 7% |
| Stigma around mental health/disease | 7% |
| HEALTH SYSTEM HAS NO SOCIOECONOMIC ROLE | 9% |
| OTHER/DON’T KNOW | 5% |
Virtually all members see prevention of illness as important (98%), and fully half see it as “extremely important” (50%).
How important is it for the health care system in Canada to prevent illness and poor health?
| IMPORTANT | 98% |
| Extremely important | 50% |
| Very important | 38% |
| Somewhat important | 10% |
| NOT IMPORTANT | 2% |
| Not very important | 1% |
| Not at all important | 1% |
| DON’T KNOW | 1% |
The most important aspect of preventive care is seen to be education on healthy lifestyles (42%), followed by hose calls/home care for those with chronic conditions (25%), and interventions in poor living environments (18%). Very few think the health care system has no role in prevention (2%)
Which of the following factors affecting preventive care is most important for the health care system to deal with?
| Education on disease prevention/healthy lifestyles | 42% |
| House calls/home care for chronic conditions | 25% |
| Intervention in poor environments/assisted living | 18% |
| Education/promotion for vaccination | 8% |
| HEALTH SYSTEM HAS NO PREVENTIVE ROLE | 2% |
| OTHER/DON’T KNOW | 5% |
Every member sees the right kind of care at the time and place it’s needed as important (100%), and more than half see it as “extremely” important (54%).
How important is it for the health care system in Canada to provides citizens with medical care at the time and in the place it’s needed?
| IMPORTANT | 100% |
| Extremely important | 54% |
| Very important | 41% |
| Somewhat important | 5% |
| NOT IMPORTANT | * |
| Not very important | * |
| Not at all important | – |
| DON’T KNOW | * |
The aspects of the right kind of care when and where it’s needed which are seen to need the most attention are reducing wait times primarily (36%), followed by reducing waste in the system (20%), involving the community more in care (14%) and more home-based care (10%). Almost none see no need for improvement.
Which of the following factors affecting timely care in the right place is most important for the health care system to address?
| Reducing wait times | 36% |
| System overhaul to reduce waste | 20% |
| More community-based care | 14% |
| Home-based care | 10% |
| More training for more medical personnel | 9% |
| House-calls | 9% |
| NO IMPROVEMENTS NECESSARY | * |
| OTHER/DON’T KNOW | 2% |
Caregiver support is important to all members (97%), and more than a third find it “extremely important” (36%).
How important is it for the health care system in Canada to offer caregiver and family support
| IMPORTANT | 97% |
| Extremely important | 36% |
| Very important | 43% |
| Somewhat important | 18% |
| NOT IMPORTANT | 3% |
| Not very important | 2% |
| Not at all important | 1% |
| DON’T KNOW | 1% |
The factors contributing to caregiver support which members think are key include caregiver respite and relief (34%), basic medical training for caregivers (24%), financial support for those who are unpaid (15%) and job protection for those who must take time off work (12%). Very few think the system has no role in caregiver support (4%).
Which of the following factors affecting caregiver and family support is most important for the health care system to address?
| Caregiver respite/relief | 34% |
| Basic training for caregivers | 24% |
| Financial support for unpaid caregivers | 15% |
| Job protection for caregivers | 12% |
| Improve social contract/working conditions for PSWs | 6% |
| SYSTEM HAS NO ROLE IN CAREGIVER SUPPORT | 4% |
| OTHER/DON’T KNOW | 6% |
Every member sees end-of-life care as important (99%), and one half see it as “extremely important” (52%).
How important is it for the health care system in Canada to offer supportive and responsive end-of-life care?
| IMPORTANT | 99% |
| Extremely important | 52% |
| Very important | 37% |
| Somewhat important | 10% |
| NOT IMPORTANT | 1% |
| Not very important | 1% |
| Not at all important | * |
| DON’T KNOW | 1% |
The most important aspect of end-of-life care is seen to be universal and simple access to palliative care everywhere (43%), followed by education on the options available at the end of life (19%). In a similar vein, choices available at the end of life should be emphasized (15%), as well as legislating the right to palliative care (13%). Very few think the system has no role at the end of life (2%).
Which of the following factors affecting end-of-life care is it most important for the health care system to address?
| Universal/easy access to palliative care | 43% |
| Education on end-of-life options | 19% |
| Emphasize care choices available at end-of-life | 15% |
| Legislating the right to palliative care | 13% |
| Teach attitude of respect in care workers | 6% |
| SYSTEM HAS NO ROLE IN END-OF-LIFE CHOICES | 2% |
| OTHER/DON’T KNOW | 2% |
Three quarters agree that a fundamental disruption of the current hospital/procedure based health care system will be necessary in order to arrive at the kind of rebuilt health care system CARP calls for (77%), and one third agree strongly (32%).
Do you agree or disagree the entire hospital and clinic-based medical establishment will have to change routines, interact more with other disciplines, give up control of much of its funding and change the way medical care has traditionally been delivered in order to allow the kind of transformational change CARP recommends for the health care system in Canada?
| AGREE | 77% |
| Agree strongly | 32% |
| Agree | 45% |
| DISAGREE | 10% |
| Disagree | 9% |
| Disagree strongly | 1% |
| DON’T KNOW | 14% |
More than 1500 CARP Poll™ online panel members responded to this poll between December 12 and 15, 2014. The margin of error for a probability sample this size is about plus or minus 3%, 19 times out of 20
