I'm going to talk about the Ontario situation, but it's comparable in other provinces. I don't know the details on other provinces. So the senior goes into hospital with an acute episode. She's at the hospital and has now gone through the acute episode. Now she's ready to leave the acute care but she can't go back home, because there isn't sufficient home care to meet her continuing needs.
The hospital under the Ontario health insurance can charge a per diem, but that per diem is limited to $53 a day, approximately, with rate reductions. Most hospital policies say if you don't take the first available bed in any home for long-term care anywhere, usually within 200 kilometres, you may be charged between $600 and $1,800 a day. That charge is illegal under OHIP. You can only charge the $53, and seniors have the right of choice. They can choose up to five homes offering long-term care. They do not have to put on their list of choices places that the hospital is directing them to. Often the hospitals will say they must choose from a short waiting list.
Please understand, I'm not naive. We encourage people to look closely at all the different alternatives, but this illustrates, first, that we don't have the home care supports for some of these people at home, and second, that we are ending up telling people they have to go 200 kilometres away from their home base, away from family and friends. This is to me systemic abuse.