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Consultation on the document “Autonomy for All”

Release Date: 10/21/2013
Staff Reference: Yves Millette

October 21, 2013

Mr. Lawrence S. Bergman
Member for D’Arcy-McGee
Chair, Committee on Health and Social Services
Secrétariat des Commissions
Édifice Pamphile-Le May
1035, rue des Parlementaires
3e étage, bureau 3.15
Québec (Québec) G1A 1A3

Subject: Consultation on the document “Autonomy for All”

Dear Mr. Bergman:

The Canadian Life and Health Insurance Association (CLHIA) deeply appreciates being given the opportunity to present its comments on the document “Autonomy for All” to the Health and Social Services Commission.

The CLHIA is a voluntary association representing corporations that hold 99% of the life and health insurance business in Canada. In Quebec, the Regroupement des assureurs à charte du Québec (RACQ) is a full member of the CLHIA. The industry markets a wide range of products essential to the financial security of some 7.2 million Quebec citizens, complementing public plans.

In June 2012, the CLHIA published a report on long-term care policy entitled “Improving the Accessibility, Quality and Sustainability of Long-Term Care in Canada”. The CLHIA document (attached) was written with the participation of organisations in the field during roundtables held in Quebec and various regions across Canada.

Access to long-term care

A structural reform facilitating the path of patients towards the most appropriate long-term care solution will not only improve the quality of care but will translate into significant efficiency savings. Health care is evolving: reduction in hospital time, the increase in the number of outpatient treatments, and an aging population with greater life expectancy are increasing the need for long-term care. Although it is true that the majority of those affected are elderly, an incapacitating illness or accident requiring long-term care can occur at any age.

We must find the best way to take care of the population. The CLHIA shares the objective laid out in the Quebec White Paper “Autonomy for All”, which states that autonomy insurance must be understood as a new impetus for long-term care, intended for people experiencing major and persistent disabilities, whether because of their age or a handicap.

Autonomy insurance complementing the coverage all citizens already receive from health and social services, provided to everyone over age 18 whose conditions and disability require support measures, appears to us to be good approach.

The issue of financing

The care and services that would be covered by autonomy insurance should not close our eyes to the amounts paid by individuals themselves for services they receive, such as the payments by adults living in residential and long-term care centres (CHSLD), fees for services in a private seniors’ residence, expenses incurred for home care, the unpaid contribution of informal caregivers, and so forth.

Based on conservative estimates, the CLHIA believes that the long-term care required by the baby boomers who will become seniors over the next 35 years will cost Canadians nearly $1.2 billion in today’s dollars. This figure is approximately equal to the market value of all the public and private registered retirement plans in Canada in 2009.

We estimate that the coverage offered by all current public programs in Canada will cover about half of the required costs. The proposed shift towards home care would make significant savings possible, and will undoubtedly improve the effectiveness of care, provided it is ensured that patients receive the best and least costly treatment possible. We estimate that governments could realise total savings of $139 billion over the next 35 years.

But $456 billion would still need to be found.

Long-term financing

The document “Autonomy for All” proposes a two-part financing strategy: For the first four years, autonomy insurance would adopt the current government financial framework with the addition of $500 million allocated through 2017-2018; the user’s contribution would be maintained. Then, with an eye to intergenerational equity, the establishment and capitalisation of a fund to ensure the financing of long-term care and services is envisaged.

Autonomy insurance would complement existing health, hospitalisation and drug insurance plans; as is the case for these plans, the insurance industry is ready to act in tandem with the proposed fund.

In recent years, the industry has begun to market insurance for critical illness and long-term care which, unlike the proposal in the document on the creation of an autonomy fund, provide for a single disbursement (as in life insurance) or periodic payments (as in disability insurance). On a complementary basis, the amounts paid out could help those with reduced autonomy to fill the gaps in their contribution to long-term health care.

Among the recommendations in the CLHIA’s 2012 report was that long-term care benefits should be based on a patient-focused approach, allowing the industry to market complementary products; and that these products should carry a tax advantage in order to encourage beneficiaries to finance their own long-term care.

Once again, we thank you for giving us the opportunity to present the position of the Canadian Life and Health Insurance Association. We would be pleased to answer questions from the members of the Commission.


(Original Signed By)

Yves Millette
Senior Vice President, Quebec Affairs