The Four Lenses of Population Aging

Patrik Marier is a professor in the Department of Political Science at Concordia University.

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