Geriatric health care policy in the United States and Canada: A comparison of facts and values in defining the problems

Abstract

Providing health care services to an aging population creates fundamental problems in how to balance the competing claims of access, quality, and cost. The definition of these problems encompasses both factual and value-laden dimensions. An understanding of how these factors shape policy development can be gained from a comparative examination of the experience of other countries in responding to the emerging geriatric health care “crisis.” In this regard, Canada has become a significant model for the organization and funding of health care services. This analysis centers on three elements of the geriatric health care dilemma: the factual basis of projections; the role played by significant social values; and the relationship between the ethics and the politics of health care. An examination of these factors reveals significant differences between the U.S. and Canada regarding how health care in general, and geriatric care in parlicular, is considered an individual right and a social responsibility. The implications of these differences for crossnational comparisons in geriatric health care policy are explored.