Canada's nursing home system, which guarantees government-paid care to all citizens, is more humane than the U.S. system at about the same cost, a long-term study concludes.
"The Canadian approach, exemplified somewhat differently in each province, has obvious benefits for the consumer," Dr. Robert L. Kane and Rosalie A. Kane, two Rand Corp. analysts, write in the current New England Journal of Medicine. "Residents do not need to impoverish themselves and their . . . spouses for nursing-home care."
Canada established a universal long-term care system in 1978. Before then, their system was similar to that of the United States -- a two-tiered system, with some people covered by private insurance or personal wealth, and others covered by government subsidy.
U.S. patients usually must exhaust personal funds before federal medical assistance helps with nursing home bills, the Kanes write.
In British Columbia, the most expensive of Canada's provinces, the average annual cost of a nursing home bed in 1982 was $15,400 in U.S. dollars, compared with $18,200 in the United States.
Yet the Canadian system offers more home care, more vacations and more assurance of a bed than the U.S. system, the researchers write.
Contrary to fears of runaway costs for home care, the researchers found that "the Canadian experience shows a consistent pattern of demand leveling off after about three years."
Last year in the United States, about half of the $26 billion spent on nursing home care came from government money.
One in four Americans who survive to age 65 will at some point be in a nursing home, the researchers predict.