A will and a way : what Americans can learn about long-term care from Canada

by Robert L. Kane, Rosalie A. Kane


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As an aid to developing reasonable public long-term-care policies in the United States, this Note describes and analyzes the ongoing experience in British Columbia, Manitoba, and Ontario, in implementing their long-term care benefits. It examines how many people used the benefits and the characteristics of the users; the costs of the programs and how they were contained; how adding nursing home benefits affected the use and costs of other segments of the delivery system and how expanded home care programs affected nursing home use; arrangements to stimulate the desired supply of appropriate services and to monitor their quality; and what problems were encountered in the evolution of long-term care from the perspectives of provincial policymakers, long-term-care providers, and citizens. The Canadian experience suggests that universal long-term-care entitlements are feasible and affordable. It shows that expanded services can be provided within a controllable budget. This Note is simultaneously being published by Columbia University Press under the title A Will and a Way: What the United States Can Learn from Canada About Caring for the Elderly.

This report is part of the RAND Corporation Note series. The note was a product of the RAND Corporation from 1979 to 1993 that reported other outputs of sponsored research for general distribution.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.