14 th Annual National Report Card on Health Care. Embargoed until August 18, 2014 at 12:01 am EDT

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1 14 th Annual National Report Card on Health Care Embargoed until August 18, 2014 at 12:01 am EDT

2 National Report on Heath Care: Seniors Health Issues and the Impact of an Ageing Population August 2014 Ipsos Reid Public Affairs One Nicholas Street, Suite 1400 Ottawa ON K1N 7B7 Tel: Fax:

3

4 TABLE OF CONTENTS Introduction... 1 Methodology... 2 Executive Summary... 3 Views on a National Health Care Strategy for Seniors... 4 Views on Retirement Readiness Additional Area of Focus: Addressing Drug Shortages... 31

5 Introduction The impact of seniors on Canada s health care system can hardly be understated. The proportion of seniors (65 years and older) within the general public is growing fast. This is largely the result of baby boomers who are getting older and living longer than ever before. A few facts illustrate the issue: In 1971, seniors represented 8% of the population; today they represent 15%. By the time that all the baby boomers have reached 65 years of age, the population of seniors may be as high as 25% of the general population. Life expectancy in Canada has grown from 75 years in 1979 to 81 years in Yet, while the population of seniors is both growing and growing older than ever before, spending on health care doesn t seem to reflect the reality. According to a recent report from the Canadian Institute for Health Information on National Health Expenditure Trends, per capita health care spending has declined over the past three years when factoring in changes to the population. Meanwhile the percentage of health dollars spent on health care for seniors has changed little in the last decade moving from 44% in 2000 to 45% in 2011, as the population of seniors has grown from 12.5% (in 2000) to 14.5% (in 2011). This report examines perspectives on seniors health care from the population with the most at stake, those 45 years of age and older. By focussing on this population, we are able to closely examine the perspectives of those who are approaching retirement age and those who are in their retirement years, as well as those most likely to be impacted by issues related to the quality and availability of care for their aging parents and spouses. The questions asked during this research deal with issues ranging from financial preparations for retirement in an age when retirement years are lasting longer than ever before, to views on the adequacy of primary and long term health care to seniors, to the impact felt by those who are themselves providing care at home to others. One perspective is particularly clear: nearly all Canadians agree that Canada needs a national strategy on health care for seniors. When we asked this question last year, as part of our National Report Card on Health Care, we found that 85% of the general public (18 and older) agreed a national strategy on seniors health care was needed. Among Canadians 45 and older, agreement was even higher at 92%. In 2014, the consensus amongst older Canadians is even stronger, with 95% saying a national strategy on seniors health care is needed. Page 1

6 Methodology Between July 17 th and July 24 th, 2014, Ipsos Reid conducted a nationally representative telephone survey consisting of a sample of 1,000 Canadians aged 45 years and older. Households were selected via random digit dialing. This sample provides a ± 3.1 percentage point margin of error for the overall national findings at a 95% confidence interval. The data was weighted by region, age and gender to ensure that the sample accurately reflects the population 45 years and older according to Census data. AGE SAMPLE SIZE n = n = n = n = 161 TOTAL N = 1,000 Page 2

7 Executive Summary Most older Canadians lack confidence in the health care system s ability to provide for seniors in the future. The majority of older Canadians are concerned with the quality of health care they can expect in the future (81%) and with having access to high quality home and long-term care in their retirement years (78%). In addition, the majority of older Canadians lack confidence that hospitals and long-term care facilities can handle the needs of Canada s elderly population (61%), or that there are enough services to help Canadian seniors live at home longer (60%). In light of this, it is hardly surprising that nearly all Canadians 45 years and over (95%) identify the need for a national strategy on seniors health care. Older Canadians are concerned about their financial situation in retirement (64%), and particularly their ability to afford health care expenses in the future (72%), their ability to afford uninsured services (70%), and their ability to afford long-term care (74%). While the majority of older Canadians (68%) have supplemental insurance today, only half (50%) say they could afford expenses not covered by Medicare. Concerns about affording uninsured services are higher among those who haven t yet retired (76%) than they are among those who already have (63%). While accessing and affording health care in old age are clearly significant concerns, the results show that older Canadians express high levels of confidence in their own planning. Most older Canadians say they will be financially prepared to live for a much longer time in retirement than their grandparents did (65%), although many (47%) say they focussed primarily on the first 10 years or so when planning their retirement (without considering living 15 or 20 years longer into retirement). Most also say they expect they will be able to leave money or other assets to family when they die (69%). And, three in four (75%) expect that they will be able to die with dignity in a place of their choosing. In light of the high levels of concern expressed elsewhere in the research, it is tempting to view high levels of confidence in their own planning as wishful thinking. Caregivers feel the burden of providing care to an aging relative or friend With over a quarter of Canadians indicating they participate in providing care to an aging relative or friend (26%), the burden of this responsibility is acutely felt. Nearly three quarters of those who participate in providing care agree that this conflicts with other personal and work responsibilities they have (71%) and six in ten agree they experience a high level of stress associated with being a caregiver (64%). Page 3

8 Views on a National Health Care Strategy for Seniors Page 4

9 National Seniors Health Care Strategy Ninety-five percent of respondents aged 45+ agree that Canada needs a national strategy on heath care for seniors. While overall agreement is high, those aged 75+ are less likely to agree compared to their younger counterparts and are actually more likely to actively disagree that a national strategy is needed. Those currently providing care to an aging relative or friend and those who are currently receiving care themselves are no more or less likely to agree than those neither providing nor receiving care. Findings could indicate that perceptions of the existing provision of health care for seniors adequately meets current needs and aging Canadians do not immediately consider the benefits or drawbacks a national strategy would offer. Those who are more likely to agree that Canada needs a national seniors health care strategy include: Residents of Ontario (96%) and Atlantic Canada (100%); Those aged (98%); Those nearing retirement in the next 10 years or next years (97%), compared to those who are already retired (94%); Those who do not have a physical or mental disability (96%). Page 5

10 In line with the majority of respondents agreeing that Canada needs a national strategy on senior s health, nine in ten (91%) agree that this would improve the entire healthcare system by finding ways to keep elderly patients living at home for as long as possible, and not in hospitals or long-term care facilities. Page 6

11 Around six in ten are not confident that hospitals and long-term care facilities can handle the needs of the elderly population. Local supremacy prevails as respondents express higher levels of agreement that they are confident that hospitals and long-term care facilities in their area can handle the needs of the elderly population, compared to Canada more generally, however confidence remains relatively low overall. Page 7

12 Over half are not confident that hospitals and long-term care facilities can handle the needs of the elderly population in their area. Respondents aged 75+, the group more likely to access such services, show higher strength of agreement that hospitals and long-term care facilities can handle the needs of the elderly population. Although confidence waivers amongst younger respondents. Those who are more likely to strongly disagree that they are confident hospitals and long-term care facilities can handle the needs of the elderly population in their area include: Women (36%), compared to men (23%); Those under the age of 74 (peaking at 33% of those aged 64 and under); Those in households with a higher annual income (peaking at 36% amongst those in households with an income between $60k - $100k); Those who do not identify as a visible minority (34%), compared to 16% of those who do; Those who provide care from an aging relative or friend (39%), compared to only 21% of those who receive care. Page 8

13 Around six in ten are not confident that there are enough services to help seniors live at home longer. While respondents aged 75+ are significantly more likely to agree that there are enough services, both locally, and in Canada more generally, overall confidence remains relatively low. Those who are more likely to strongly disagree that they are confident that there are enough services to help seniors live at home longer in Canada include: Women (35%), compared to men (24%); Those with a higher level of education (33% amongst those who have attained a university degree or higher); Those who do not identify as a visible minority (32%), compared to those who do (22%); Those who provide care from an aging relative or friend (36%), compared to 25% of those who receive care. Page 9

14 Around six in ten are not confident that there are enough services to help seniors live at home longer. Younger respondents aged are more reluctant to agree that there are enough services to help seniors live at home longer compared to their older counterparts aged 75+. Those who are more likely to disagree that they are confident that there are enough services in their area to help seniors live at home longer include: Younger respondents aged (peaking at 62% of those aged 55 64); Those in households with a higher annual income (peaking at 64% of those in a household with an income of $100k+); Those who do not identify as a visible minority (59%), compared to 45% of those who do; Those who provide care to an aging relative or friend (65%), compared to those who receive care from a relative or friend (38%). Page 10

15 The majority of respondents are concerned about their access to high quality home care and long term care in their retirement years. When asked their level of concern about having access to high quality home care and long term care in their retirement years, eight in ten (78%) indicate they are or were very or somewhat concerned. Thinking back to when they were preparing for retirement, 69% of those who are already retired said they were concerned about the quality of care they would have access to. Those now approaching retirement show higher levels of concern, with 43% being very concerned, compared to 32% of retirees who said they were very concerned when planning for their own retirement. Women are generally more concerned about having access to high quality home care and long term care in their retirement years. Page 11

16 In line with high levels of concern about access to high quality home care and long term care in their retirement years, eight in ten respondents are concerned about the quality of healthcare they will receive in the future. Those approaching retirement are particularly concerned with the quality of healthcare they will receive in the future. Men and women show relatively equal levels of concern, as do those across all income brackets. Those who provide care to an aging relative or friend are particularly concerned (88%), compared to those who receive care (76%). Page 12

17 Concerns about Health Care for Future Generations Compared to their concerns about their own future access to and quality of health care services, fewer spend time worrying about the generation that is following them and their potential lack of pensions or quality health care services. Seven in ten (72%) do agree that they spend a lot of time worrying about the generation that is following them, particularly amongst those aged (77%). Those who are more likely to strongly agree that they spend a lot of time worrying about the generation that is following them include: Those in households with a low annual income (45% amongst those in a household with an income of less than $30k); Those who are already retired (43%). Page 13

18 Ability to Afford Health Care Costs Nearly seven in ten have supplemental health insurance to cover medical costs which the public health care system does not. The prevalence of having supplemental health insurance decreases with age, with only 53% of those aged 75+ having additional insurance. Around eight in ten of those who are not yet retired currently have supplemental health insurance, in most cases through a current employer (32%), or alternatively, through their spouses plan (14%), purchased private insurance (12%) or through a previous employer (10%). Those who are less likely to have supplemental health insurance include: Those who identify as a visible minority (42%), compared to 27% of those who do not; Those with a physical or mental disability (40%), compared to 29% who do not; Those who do not have children (33%); Those who receive care from a relative or friend (51%). Page 14

19 Awareness of Non-Public Health Care Costs The majority of respondents are aware that many of the health care costs they may incur later in life are not covered by the public healthcare system. While 83% of respondents who are not yet retired are aware that many of the health care costs they may incur later in life are not covered by the public healthcare system, 17% are unaware of the costs they can expect to pay. Those aged were more likely to answer No indicating they were not aware that many of the health care costs they may incur later in life are not covered by the public healthcare system (21%). Page 15

20 Ability to Afford Extra Services Only half of respondents agree they can afford or will be able to afford to pay for the extra health care services that are not covered by Medicare or their health insurance if they want to. Younger respondents, who are arguably further from retirement than their older counterparts, are more likely to agree that they will be able to afford to pay for the extra health care services not covered by Medicare or their own insurance during their retirement years. Those less likely to agree that they can afford or will be able to afford to pay for the extra health care services that are not covered by Medicare or their health insurance if they want to include: Those who identify as a visible minority (40%); Those with a physical or mental disability (40%). Page 16

21 Views on Retirement Readiness Page 17

22 Concerns about Retirement Six in ten were concerned or are concerned about their financial situation in their retirement years. Those approaching retirement in the next 10 years are less likely to be concerned about their future financial situation. The optimism of younger respondents, who are more likely to agree that they will be able to afford to pay for the extra health care services not covered by Medicare or their own insurance during their retirement years, is not supported when directly asked how concerned they are about their financial situation in their retirement years. Levels of concern amongst those aged (69%) and those aged (66%) are significantly higher than their older counterparts aged (58%) or 75+ (52%). Page 18

23 Concern grows when respondents are asked to consider their ability to afford health care expenses in the future, such as having enough money to pay for uninsured services, rather than their financial situation in general. Amongst those who are not yet retired, it is women and those living in middle income households (earning between $30k $60k annually) who are significantly more likely to be concerned about their ability to afford health care expenses in the future. Page 19

24 Half of respondents were concerned or are concerned about maintaining the same standard of living for their spouse or partner, if they should die first. Those who do not expect to retire for another years were more likely to indicate they are concerned about maintaining their partners standard of living. Amongst those who are already retired, it is men who are significantly more likely to be concerned (48%), compared to women (39%), which may be the result of men s shorter life expectancy. 1 1 In 2009, life expectancy at birth was 78.8 years for men and 83.3 years for women (Source: Statistics Canada. Life expectancy, at birth and at age 65, by sex, Canada, provinces and territories, annual (years) (CANSIM Table ). Ottawa: Statistics Canada, Page 20

25 Three quarters of respondents were concerned or are concerned about having enough money to pay for a long stay in a long term care facility or a long period of nursing care at home. Page 21

26 Preparations for a Longer Retirement Over six in ten agree that their own financial preparations will allow them to live for a much longer time into retirement than their grandparents did. Page 22

27 When preparing for their retirement, fewer than half of respondents have considered living 15 or 20 years, or longer, into their retirement. Page 23

28 Younger respondents (aged 45 54) and older respondents (aged 75+) are more likely to agree that Canada s health care system has kept pace with patients longer life expectancy. Respondents aged are significantly less likely to agree this is the case. Those who are more likely to agree that Canada s health care system has kept pace with patients longer life expectancy include: Those living in households with a lower annual income (peaking at 56% amongst those in households with an income of less than $30k); Those who identify as a visible minority (59%), compared to 45% of those who do not; Those who receive care from a relative or friend (65%). Page 24

29 Those closest to retirement age (55 64 years old) are significantly less likely to agree that they have saved enough money or have a good enough pension that they will be able to leave some money or other financial assets to their family when they die. Page 25

30 Amongst those who agree, it is men and those over the age of 75 who appear to be more confident that they will be able to die with dignity in a place of their choosing. Those who are more likely to disagree include: Women (26%), compared to 19% of men who disagree; Younger respondents (24% amongst those aged and 26% amongst those aged 55 64); Those living in households with a lower annual income (29% amongst those in households with an income of less than $30k). Page 26

31 Responsibility for Others Over a quarter of respondents participate in providing care to an aging relative or friend. While younger respondents are more likely to indicate they participate in providing care to an aging relative or friend, there is no statistical difference by gender in the propensity to provide care. In addition to younger respondents and women, those who are more likely to participate in providing care to an aging relative or friend include: Those living in households with a higher annual income (peaking at 31% amongst those in households with an income of $100k+). Those who are more likely to be receiving care from a relative or friend include: Those living in households with a lower annual income (peaking at 14% amongst those in households with an income of less than $30k); Those who identify as a visible minority (9%); Those with a physical or mental disability (24%). Page 27

32 Nearly three quarters of those who participate in providing care to an aging relative or friend agree that this does conflict with other personal or work responsibilities they have. While women are no more likely to act as a care giver to an aging relative or friend, they are significantly more likely to strongly agree that being a care giver, even if only occasionally, does conflict with other personal or work responsibilities. Page 28

33 Of those who participate in providing care to an aging relative or friend, over six in ten agree that they experience a high level of stress because of this. Once again it is women who are significantly more likely to agree that being a care giver does cause them to experience a high level of stress. Page 29

34 Those aged are significantly more likely to agree that they will have both children and parents that they have to physically care for or who they will be financially responsible for when they are in their own retirement years. Men are significantly more likely to agree that they will have children that they are / will have to physically care for or who they will be financially responsible for during their own retirement years. Page 30

35 Additional Area of Focus: Addressing Drug Shortages Page 31

36 Addressing Drug Shortages Ninety-five percent of respondents agree that it is important for the Government of Canada to take steps to address the issue of drug shortages in Canada. Page 32

37 In regards to mitigating the impact of drug shortages, eight in ten respondents indicate a response of Yes when asked if they think the Canadian Government should take the same actions as the US to control the supply and availability of prescription drugs, such as imposing substantial fines for pharmaceutical companies that do not maintain adequate supplies of prescription drugs. Page 33

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