By Steve Moran

He is also hopping mad at most of you!

I received this email today from a short-term reader, someone who signed up for the “Our Time to Shine” virtual summit. I won’t use his name without his permission but I googled him and it is apparently a significant voice in Canada:

“Please take me off this list. From my perspective — and it’s a point of view that is shared quite widely here in Ontario and Canada — that private business has no constructive role to play in long term and senior care. The fact that private business is allowed to play such a prominent role in this sector is as destructive as having the same interests operate in the health care sector as a whole.

Providing a soapbox for businesses that make profits off of seniors (or any health care areas) is pretty low, indeed.”

As I do with all critics I have offered him our platform to make his case, though in all the years making this offer to critics I have only had people take me up on it two or three times.

I share this with you because, while I think it is a minority point of view, I do think there are a significant number of people in the US and Canada that agree with him. I did respond to him via email and have as of yet not received any response . . . though it’s been only a few hours.

Three Ownership Models

There are really just three possible ownership scenarios (with some variations on a theme): government-owned, not-for-profit owned, or for-profit owned. As Jack Cumming points out, the difference between not-for-profit and for-profit is primarily an income tax status and does not particularly, in the area of senior living, represent a mission to serve people in need.

Disturbingly there is at least one not-for-profit that does or did openly advertise that well-heeled older people should buy into their community because they could take the tax savings and use it to the benefits of the residents.

Why He Is Wrong

Here is my list of why he is wrong:

  1. Not-For-Profit (NFP) nursing homes have not been spared from either infections or deaths. One of the benefits that many NFP nursing homes have is that many of them serve a predominately private pay clientele as part of a CCRC. It means more private rooms and more financial resources for things like PPE and staffing.
  2. If you do a search for VA Nursing Homes and COVID-19 you will find scads of stories of high infection rates and deaths in these government-owned, government-controlled facilities.
  3. In the US most of the low-income nursing care (85%) is done by for-profit nursing home organizations. Most NFPs have shown little interest in this segment of the senior living world because the dollars are so terrible.
  4. It would be helpful to understand how, If you were to close all of the for-profit senior living communities in the US and Canada, where those older people would live.
  5. In both the US and Canada most of the hospitals are run by NFP organizations or the government and they have done a very poor job of containing costs.
  6. There are good and bad operators in all three categories of ownership and this is true in the private and public sectors. Consumers have to take some responsibility for the choices they make when choosing senior living.

What makes me uniquely sad about people who feel this way is that while they believe sincerely they are helping old people they are in reality harming them. Making life for older people much more difficult.