The Four Lenses of Population Aging: Planning for the Future in Canada’s Provinces
Published: May 2021© 2021
368 Pages, 6.00 x 9.00 x 0.80 in, 7 b&w illustrations, 6 b&w tables
With its implications for health care, the economy, and an assortment of other policy areas, population aging is one of the most pressing issues facing governments and society today, and confronting its complex reality is becoming increasingly urgent, particularly in the age of COVID-19. In The Four Lenses of Population Aging, Patrik Marier looks at how Canada’s ten provinces are preparing for an aging society. Focusing on a wide range of administrative and policy challenges, this analysis explores multiple actions from the development of strategic plans to the expansion of long-term care capacity. To enhance this analysis, Marier adopts four lenses: the intergenerational, the medical, the social gerontological, and the organizational. By comparing the unique insights and contributions of each lens, Marier draws attention to the vital lessons and possible solutions to the challenges of an aging society.
Drawing on over a hundred interviews with senior civil servants and thousands of policy documents, The Four Lenses of Population Aging is a significant contribution to public administration, provincial politics, and comparative public policy literatures, and a timely resource for policymakers and general readers seeking an informed perspective on a timely and important issue.
Facing the consequences of an aging population
Purpose of this book
Why focus on Canadian provinces?
Why focus on civil servants?
Chapter 1 – The Lenses of Population Aging
The Intergenerational Lens
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
The Organizational Lens
Conclusion – Policy Lenses in Public Administration
Chapter 2 – Population Aging as Policy Problems
Linking policy problems with population aging lenses
Defining what is the problem
Solutions to policy problems
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
Chapter 3 – The Politics of the Long View
The rise and fall of planning
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
Policy capacity within the civil service
Professionalization of the long view
PUBLIC POLICY AND POPULATION AGING
Chapter 4 - Pensions
Historical overview and current structure of Canada’s pension policy
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
Chapter 5 – Health and Residential Care
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
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
Chapter 6 – Home Care Services and Caregiving
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?
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?
Social gerontology lens
PUBLIC ADMINISTRATION AND POPULATION AGING
Chapter 7 – Central Agencies and Inter-Ministerial Coordination
The organizational lens and policy problems
Monitoring the consequences of population aging in Québec
A unique initiative spearhead by a central agency in Nova Scotia
Alberta’s approach to aging population
Chapter 8 – Offices for Seniors
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
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
Revisiting the four lenses of population aging
Social gerontology 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
"Marier’s new book is a treat for gerontologists as well as for policy-oriented readers who might appreciate this study of how different provinces have implemented policy responses to issues arising from population aging. The book is a tremendous accomplishment based on more than ten years of research in ten provinces, including analyses of public documents and 125 key informant interviews."Laura M. Funk, University of Manitoba, Canadian Journal on Aging
"The Four Lenses of Population Aging is an excellent book. It combines theoretical sophistication, comprehensive coverage, and writing that is lively and accessible to a variety of audiences. The author's passion for his subject and deep knowledge shine through on every page. It will be the standard resource on aging policy in Canada for many years to come."Kent Weaver, Professor of Public Policy and Government, Georgetown University
"Population aging is a major issue which affects many developed countries and will affect many others in the coming decades. Patrik Marier provides a detailed and sophisticated analysis of the experience of Canadian governments in developing policies in specific areas from pensions and health care to residential care. Setting out four lenses through which to observe aging, Marier shows how each influences policy solutions to deal with aging. The book reveals how each lens emphasizes different elements in aging populations and favours different policy instruments and mechanisms to alleviate related policy problems, highlighting the difficulties associated with developing cohesive strategies to tackle the challenges, and seize the opportunities, related to aging populations."Michael Howlett, Burnaby Mountain Professor and Canada Research Chair (Tier 1), Simon Fraser University