Abstract

The objective of the presentation is to point out the main issues surrounding long-term care in the province of Québec and to discuss the potential policy options that could help solving these issues: limited public insurance coverage, impact of the recent health care reform on access for specialized health care, issues regarding the respect of human rights, conciliation of public care and private life.

Limited public insurance coverage: In Québec, only elderly with high health care needs have access to public coverage for long-term care and housing. Therefore, only the elderly – with mid-health care needs – and covered by a private insurance have a decent and complete health care and housing access. A few years ago, it was proposed to create a public insurance specific to long-term care. This proposal was however rejected by new government. We propose to revisit this proposal and to evaluate its viability with regards to the actual political and economic context in Quebec.

Impact of the recent health care reform on access for specialized health care: The recent health care reform in Quebec has merged a considerable number of health care facilities. Since then, long-term care for remote residents have been increasingly complex. We propose to point out the state of the situation and to evaluate what policy and legislative amendments should be considered in order to provide better long-term care for elderly.

Issues regarding the respect of human rights: The limited access to long-term care in Quebec in now rising concerns regarding its potential impact on the respect of some of the rights guarantee by Canadian Charter, such as the ‘security’ right. In 2005, the Supreme Court of Canada, in Chaoulli, has granted a considerable weight to this right in the context of access to care. It is now pertinent to evaluate if the Supreme Court reasoning can, or cannot, be applied to the case of access to long-term care in Québec. In the affirmative, there would be an urgent need to rethink our long-term care policy.

Conciliation of public care and private life: Residents in long-term care public housing have different needs, including sexual needs. How can we conciliate these needs and the fact that these residents might not have the abilities, by themselves, to meet these needs? Should these residents be helped in meeting their needs? In the affirmative, what form this help might take?

Considering the legal background of the speaker, the presentation will focus on the laws and regulations surrounding these issues. An overview the legal implications of new policies for improving the state of elderly in the province of Quebec will also be provided.