A rapidly aging population is just one of many health system challenges facing BC's next government.

We have been surprised, to say the least, at the lack of public discourse around health care during this election period. As a top-of-mind issue for British Columbians, you'd think it would be as central as the always large and looming economy. So what are the burning issues in health care, and how do the party platforms stack up? Here's our take, with a particular focus on seniors.

The challenge:

When we talk about "health care" we're talking about a large and complex system that includes three major areas: primary care (family doctors and health centres), acute care (hospitals and emergency services), and home and community based care (services for seniors and others who require support in their homes, communities or residential facilities). There are also issues related to technology, drugs, education and training, funding models, integration across different parts of the system, patient rights, privatization... and more.

Health care is by far the largest expenditure in the provincial budget. Dire warnings in recent years about the financial "sustainability" of Medicare have prompted fears that aging baby boomers will soon overwhelm the system, leaving few resources for the needs of younger generations. The CCPA has published extensively on this issue, pointing out that it is the costs associated with new health technologies, such as new surgical techniques, diagnostics, prescription drugs, and end-of-life interventions that are key cost drivers, not the growing number of seniors. And our research has shown how we can improve access to surgical care and prescription drugs while also helping to contain costs.

But when it comes to seniors and the aging population, the home and community care system is particularly vital. Ask any community seniors group in B.C. how this system is doing and you're likely to hear a similar story: it's more of a fragmented patchwork of services than a system, it is extremely confusing to navigate, and seniors and their families are ending up in impossible situations as a result. It is a story well-documented by B.C.'s Ombudsperson in her recent landmark systemic investigation into the crisis in seniors care.

Problems of underfunding and lack of coordination date back to the 1990s, but worsened significantly over the last decade due to reduced access to services and poorly planned restructuring. Between 2001/02 and 2009/10, for example, access to residential care dropped by 21 per cent, and access to home support dropped by 30 per cent. As the July 2012 CCPA study, Caring for BC Aging Population: Improving Health Care for All finds:

The impact of these changes can be seen in the 35 per cent increase since 2005/06 in hospital beds occupied by patients who couldn't be discharged because the appropriate residential or home health services were not available.

See more here:

Ghost Issue? Health Care and the Aged (in Opinion)