Population aging and the impact on health care: A view from near centre

Two recent reports on population aging (from the Fraser Institute and the Canadian Centre for Policy Alternatives) propose contradictory conclusions about the sustainability of publicly funded health care in the face of population aging. We argue that each side makes dubious assumptions that constrain their analyses and the options that they can produce. Instead,health analysts should consider how technology impacts on the care of older adults who are frail, and how to minimize the perverse incentives in health care that especially compromise its effectiveness for its heaviest users. We emphasize that reform must avoid the trap of giving over to the private sector the chance to charge for ineffective but expensive care, targeted to "one thing wrong" older adults, while leaving the frail to a diminished public system.