There are significant policy and economic challenges in the Canadian healthcare system relating to the frail elderly. Two-thirds of Canadians are worried that our health system is falling behind. Elderly patients often have more than one chronic disease, and in fact, often have multiple morbidities, including cognitive impairment. However, frailty goes beyond just seniors, affecting all ages and can be a significant piece of chronic disease. Flat lined economic growth, combined with our aging workforce, means the supply of tax revenue will decrease. These changes in the economic context are requiring governments to shift policy action to more patient-centred care and shift spending from hospitals to primary and community care.