Going once, going twice... Health care giants bid for home care

 Cashing in on need

 Ontario: Primed for costly privatization

 The cost of competition

 Staffing problems

 Out of pocket expenses on rise

 Funding and access cutbacks

 Home care is about women

 The need for federal action

 For-profit home care provision: expanding the market

 Olsten’s shoddy track record

 What is your province doing?

 Corporate classrooms costly...

Who’s minding the house?

There are no reliable, comprehensive or publicly available statistics on private home care expenditures, despite the resources invested in analyzing health care spending by Health Canada, Statistics Canada and the Canadian Institute for Health Information. How much are people really paying out of their own pockets for home care? How much government money is being used to fund private sector delivery of home care?

While Health Canada’s home care division collects information on private home care spending, it is shrouded in secrecy. A recent Access to Information request was denied on the grounds that releasing the information could harm federal-provincial consultations or deliberations.

This information must be made public. It is an important part of the case for a national Home and Community Care Act. Far from harming federal-provincial deliberations, information on private home care spending must be part of the public debate on a publicly-funded and publicly-operated home care system.

For-profit home care provision: expanding the market

Profit makers’ interest in the home care "business" does not always stop at nursing and homemaking care. The next frontier appears to be one-stop shopping for health care products and services. Reports indicate some home care companies are working closely with pharmaceutical companies to enlist their patients in clinical drug trials. Dynacare and Comcare are partners in a Toronto-based firm, Dynacare Clinical Research Inc., which provides "clinical trials services" to pharmaceutical and biotechnology companies. Because home care recipients must pay for their own drugs, unless they are eligible for the provincial pharmacare plan, many may feel pressure to participate in clinical drug trials in order to receive the drugs for free. This dangerous trend must not be allowed to continue.

In July 1999, the US home care contractor Olsten issued a press release about its work with Apria, a multinational US-based company which sells medical equipment and respiratory therapy services. Being in the home of a vulnerable patient (or what Olsten may call "client" or "consumer") may be the ideal time and place for private companies to sell their products.

The dangerous blurring of what should be a clear line between caregiver and salesperson must end. The only way to ensure Canadians receive quality, accessible home care is to ensure that home care is publicly funded and publicly delivered — the record of the for-profit providers speaks for itself. As Canada’s population continues to grow, caring for profit cannot become the norm for seniors, recovering patients and people with disabilities.

Home care has the potential to be a vital component of a well-functioning health care system. Swift action to halt the privatization of home care will require a strong federal commitment to work with the provinces, assuring future generations access to a public system that provides the care they need and deserve.