The Four Lenses of Population Aging

Introduction Facing the consequences of an aging population Purpose of this book Why focus on Canadian provinces? Why focus on civil servants? Methods Content THEORETICAL UNDERPINNING Chapter 1 – The Lenses of Population Aging Introduction The Intergenerational Lens Generational accounting Dependency ratio Musgrave rule Generational politics The Medical Lens Population aging – a rising number of seniors with special needs Geriatrics – a marginalised specialty in medicine Health promotion or how to age successfully The Social Gerontology Lens The “new” or “positive” gerontology Critical gerontology Political economy The Organizational Lens Conclusion – Policy Lenses in Public Administration Chapter  2 – Population Aging as Policy Problems Introduction Linking policy problems with population aging lenses Defining what is the problem Causality Severity Novelty Proximity Complexity Problem population Solutions to policy problems Solvability Monetarization Governmental capacity Interdependencies Interactions between the lenses: Co-existence, complementarity, and competition Intergenerational and medical lenses Intergenerational and social gerontology lenses Intergenerational and organizational lenses Medical and social gerontology lenses Medical and organizational lenses Social gerontology and organizational lenses Conclusion Chapter 3 – The Politics of the Long View Introduction The rise and fall of planning The fall The revival: Old wines in new bottles? Thinking and action with a long view in the public sector What is the long view How to promote the long view within the public sector? What facilitate or impede the long view in Canadian provinces? Politicization of the civil service Leadership   Policy capacity within the civil service Professionalization of the long view Institutional mechanisms Conclusion PUBLIC POLICY AND POPULATION AGING Chapter 4 - Pensions Introduction Historical overview and current structure of Canada’s pension policy CPP/QPP Occupational pensions Private alternatives What solutions for pensions? CPP, ORPP, and new occupational tools What is wrong with the Canadian pension system? The Harper years: Lack of consensus led to multiple provincial initiatives Provincial commissions on occupational pension plans Pooled registered pension plans and Québec’s Voluntary Registered Savings Program Provincial earnings-related pension schemes: The longevity pension and the ORPP The longevity pension The Ontario Retirement Pension Plan The Liberal years: Improving the CPP, occupational pension plans, and new alternatives A lens analysis of the pension debates Conclusion Chapter 5 – Health and Residential Care Introduction Health care expenditure Overview of health care expenditure in Canadian provinces Population aging and health care expenditures Views from civil servants Long Term Care – Residential care A continuum of care? The geopolitical and economic realities of residential care Human resources Analysing the four lenses in health policy The intergenerational lens embedded within the crowding out problem definition Dominance of the medical lens and the marginalisation of the social gerontology lens Organizational lens – Expanding the health perspective into other bureaus COVID-19 and the Long-Term Care Crisis of 2020 Conclusion Chapter 6 – Home Care Services and Caregiving Introduction Home care services in Canadian provinces What is home care? The Canadian context of home care – common challenges Classifying home care models in Canada The role of partisan politics Home care as policy failure? Caregiving A De-familializing model? Caregiving policies across Canada and recent developments Impact on health status, labour market, and retirement income Home care as a universal solution for population aging? Intergenerational lens Medical lens Social gerontology lens Organizational lens Conclusion PUBLIC ADMINISTRATION AND POPULATION AGING Chapter 7 – Central Agencies and Inter-Ministerial Coordination Introduction The organizational lens and policy problems Central agencies Executive council Monitoring the consequences of population aging in Québec A unique initiative spearhead by a central agency in Nova Scotia Finance Ministries Inter-ministerial coordination Alberta’s approach to aging population Informal channels Conclusion Chapter 8 – Offices for Seniors Introduction The Creation (and Expansion) of Offices for Seniors A diversity of organizational settings Councils on aging What Do Offices for Seniors Do? Dissemination of information Consultations Coordination of seniors’ related issues and programs Policy instruments and policy input The Tension Between the Social and Medical Lenses Embracing healthy aging A return to the Ministry of Health? Still a social perspective? Long Term View Facilitating a long term perspective Obstacles to implement a long term horizon A Third Wave of Offices for Seniors? Seniors’ Advocate Offices Conclusion: Divergent Path for Seniors’ Offices CONCLUSION Conclusion Revisiting the four lenses of population aging Intergenerational lens Medical lens Social gerontology lens Organizational lens Revisiting the theoretical expectations on the long view Federalism, population aging, and policy diffusion and learning The continuing marginalisation of social policies and its consequences in the context of an aging population and the challenges of COVID-19