In this book, Patrik Marier presents the reader with a comprehensive guide to policy thinking, policy action, and the ways in which governments in Canada are preoccupied—or not—with population aging. He argues that debates continue about the extent to which population aging will require fundamental reform of public policies. Yet provinces and the departments within them treat aging differently, often in ways that are contradictory. He cites obstacles to comprehensive policy directions, including the uneven impact of population aging across provinces and the need to account for multiple aspects of life, from housing to health. He argues that the slow and gradual process of population aging has lulled governments into implementing short-term, ad hoc measures that lack the long-term vision needed to address the challenges and opportunities presented by population aging.
The main thesis in the book is that provincial governments differ in their perspectives on the aging problematic and its policy solutions. To understand the sources of these diversities, he employs the metaphor of camera lenses. Each has a different focal point; each determines what we see; each leads to a set of policy actions. The intergenerational lens views population aging as having created adversaries between baby boomers and younger cohorts, requiring “generational accounting.” The medical lens represents population aging as creating a tsunami of escalating costs of (acute) health care needs. The social gerontology lens emphasizes social aspects of aging, challenges ageism and focuses on groups of older adults that are marginalized. Finally, the organizational lens frames the key difficulty arising from the horizontal nature of this policy issue that is relevant across departments, from finance to immigration to public health.
In the introduction to the book, Marier describes population aging as “a ubiquitous concern affecting countless policies and programs in Canada” (5). He positions the purpose of the book as a comprehensive analysis of how provinces have addressed this major contemporary policy concern. The result is a critical, in-depth analysis of the provincial public policy terrain that both public policy scholars and gerontologists will find attractive, engaging and useful.
Public policy scholars will recognize his framing of policy problems related to population aging within the public policy literature. What they will see is an impressive, comprehensive analysis of Canadian public policy. An example is the question of whether public authorities can plan for future events, given the “short term myopia of elected officials” (76). He illustrates this point with a brief history of the Canada Pension Plan and the Quebec Pension Plan. Both plans were introduced in the 1960s, and only two provinces had actuaries evaluate their long-term consequences. Policy experts who read the book will gain insights into contemporary framing of social issues that affect all Canadians, including the history of pension debates and the contemporary fragmentation of programs and solutions, despite 60 years of discussion.
Gerontologists will recognize the intergenerational, medical and social lenses as being closely aligned with contemporary theoretical and empirical work on aging. For these scholars, the lenses provide new perspectives on the long, convoluted path from creating the evidence to having it taken up in ways that influence the lives of older persons. In his analysis of home care and family care, Marier concludes that governments place low priority on support to older persons with chronic conditions. His illustrates the pre-eminence of the medical lens, where home support services are underfunded and family carers are pressured to address their shortcomings. Motivating the development of policy tools to address the well-documented care crisis seems fertile ground for collaboration between gerontology and policy scholars.
Given the excellent work of this book, I am left with regrets about policy terrain that is unexplored. Foremost among these is that the Territories were not included. We have so little understanding of the policy processes and approaches to population aging in which they are engaged or of how their invisibility to the rest of the country excludes. And then there is the federal government of Canada, with its vertical organizational approach and resistance to generating a broad and comprehensive aging strategy. I hope that a book that explores this policy terrain is already in process.
