Recognizing the Magnitude of the Challenge

"Funding Long-Term Care in Canada: Issues And Options" (Adams and Vanin 2016) is a well-argued paper that grounds its recommendations in learnings from other jurisdictions that have tried to enact major reforms to the funding approach for long-term care (LTC). In particular, the paper considers the experience in both the UK and Quebec. The paper correctly highlights the significant difficulty of implementing large structural reforms to deal with LTC funding challenges. This is not a surprising result. Structural reform in healthcare has proven challenging even when the problems being addressed are immediate and large in scale, let alone for those that will manifest themselves in increments over many years or even decades in the future. The authors are correct, in my view, to focus on the art of the possible and to seek ways to set Canada on a path towards addressing the coming challenges around LTC, rather than proposing a big-bang fix.