Seniors will not bankrupt Canada's health system

By Kimberlyn McGrail
Published in The Lancet, November 17, 2012


Paul Webster's World Report, “Can Canada reckon with its health costs?” (Sept 8, p 875) (1) suggests that our ageing population is putting the main financial strain on the Canadian health-care system. The story states that caring for increasing numbers of elderly patients with expensive-to-treat chronic health conditions” will inflict “stinging new costs” and represents a “coming chronic care crisis”. In other words, the diagnosis is demographics. Unfortunately, the evidence suggests that the diagnosis is somewhat more complex than this.


Yes, an ageing population does lead to more health-care spending, as the reputable experts in your report highlight—but that's only part of the story. As research shows (2), ageing constitutes only a small and predictable portion of the rising costs of health care in this country: a manageable 1% per year increase.


Of greater financial concern is an increasing intensity of care for all age groups, and rising costs for medical screening and diagnostic tests, prescription drugs, and doctors' fees (3). All patients are also using significantly more publicly funded health services than a decade ago (4). Whether they're 50 or 85, Canadians are seeing more specialists and undergoing more tests. They're also taking more drugs and often more expensive drugs than before (5).


Boomers aren't to blame. It isn't the ageing population per se that threatens the sustainability of our health-care system, but the interaction of that growing population segment with current shortfalls in health-care delivery, including poor coordination of services, and, in many cases, unnecessary use of some health products and services.


Instead of creating a generational divide by pointing the finger at our seniors, now is the time to have a deeper discussion about how best to reform our health system to ensure our seniors—and everyone else—receive quality care, when and where they need it.