American and Canadian Health Care

This is a special guest blog post by our Executive Director, Alanna Hendren, on health care in Canada and the United States, and how it relates to people with developmental disabilities.

health symbolThe Health Care debate in the U.S. is providing some great opportunities for positive changes in federal and state legislation regarding people with disabilities.    The current bill proposed by the Senate Finance Committee, called “America’s Healthy Future Act” is a mix of individual responsibility, government subsidies and the creation of a health-exchange.  Insurance reforms such as eliminating pre-existing conditions clauses are also included.

It is difficult for us Canadians to imagine a system where people do not have universal access to healthcare services, particularly for people with developmental disabilities.  In the U.S., Medicaid is the only program where non-senior citizens can get payments for their health care needs, but in order to qualify the proposed legislation would standardize eligibility for Medicaid for all parents, children, pregnant women and adults at or below 133% of the Federal Poverty Level, or $30,000 for a family  of four – $14,400 for an individual.  Prescription drug benefits would also be extended to all Medicaid beneficiaries under the proposed plan.

Recognizing that qualified health care providers are in low supply in the U.S., the Senate bill also includes provisions for two demonstration grant programs that benefit the work force.  One program provides financial and supportive assistance to eligible low-income people who are receiving education for health care jobs, including direct-care and community support positions.  The second program will develop a set of core training competencies and certification programs for personal and home-care aides throughout the country.

The Federal Office of Disability Employment Programs has also provided major funding for the Campaign for Disability Employment, which aims to encourage employers and others to “recognize the value and talent that people with disability bring to the workplace.”  The Campaign is the result of lobbying by the American Association of People with Disabilities, Special Olympics, the National Business and Disability Council and the U.S. Business Leadership Network.  The website for the Campaign is at

The U.S. Department of Education has also received $11.37 billion for elementary and secondary education, Individuals with Disabilities Education, and Vocational Rehabilitation.  Of the $11.37 billion in funding, $6.1 billion has been released for Individuals with Disabilities Education and will provide states, school districts and early intervention service providers with additional funding to improve outcomes for infants, toddlers, children and youth with disabilities and will also stimulate the economy.  $270 million in Vocational Rehabilitation funding will improve employment outcomes for people with disabilities.

In Canada, the federal government has virtually no involvement in services or supports for people with developmental disabilities and in British Columbia, we have seen the direct-care and community workforce decrease substantially in favor of “home-care” or other models that do not require pay much over minimum wage.  Funding for special education and early intervention continue to be insufficient to meet the needs of children who are on waitlists or receiving diluted services.  Although Community Living BC (CLBC) is stressing ‘jobs first’, there has been nothing more than token funding invested to make jobs a sustainable reality for adults.  Vocational rehabilitation used to be an area where the federal government played a fundamental role, but now these supports have been passed on to the provinces to provide, with predictable results.  Affordable housing is another area where families, self-advocates and service providers continue to face major obstacles in both the U.S. and Canada.

The economy is certainly no worse in Canada than it is in the U.S., so it is particularly disturbing that we have seen cuts during good times and now we will see more cuts during bad times.  The great blessing is that we all have healthcare, so families can at least have the security of knowing that treatments for physical disorders are fully funded.  What families also need, however, is to know that their loved one is maximizing their full developmental potential and is supported to live a safe life in the community – two areas where we are falling behind our neighbors to the south, east and many places around the world.


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