Long-term care in Canada is situated within a universally accessible publicly insured program. The Government of Canada establishes certain minimum standards for health care as the basis for the federal share in funding health programs, although the programs themselves are administered provincially. Examples are drawn from the Province of Manitoba. While the dependency ratio has been decreasing due to a slower increase in the number of persons under 17 years of age, the percent of the population over 65 years continues to increase. Population projections forecast that by the year 2031, one-quarter of the population of Canada will be over 65 years of age. Expenditures on health care doubled from 1981 to 1990 for both Manitoba and Canada. The policy response to ever-increasing costs of delivering health care to an aging population has been to seek alternative methods of delivery. Specifically, the long-term care bed-to-population ratio has been reduced and the authors anticipate continued modest increases in the use of community care.
