November 18, 2008
Is the Canadian Healthcare System on life support?
As chair of the Health Council of Canada, and former chair of the National Board for the Canadian Institute for Health Information, Michael Decter gave us interesting and enlightened insights last November 18 on the state of our healthcare system and the outlook for the future – and it’s not as bleak as you may think. Personable and unassuming, the morning got off to a great start – no PowerPoint slides!
When the healthcare system was first introduced in Canada, it was designed to provide acute care. As Canadians are now living longer and longer, the system must now deal with managing chronic illnesses. The shift in focus is happening but it does take time.
According to Mr. Decter, the 5 major forces driving change in the healthcare system today stem from the following main concepts:
1. Investment in broader health
Apparently, only 25% of our longevity is connected to the healthcare system—the other 75% is connected to our genes, our environment and our lifestyle choices. As a result, the shift to investing in broader health has taken shape to balance the healthcare investment. In addition, governments are commissioning services, running bidding processes or bidding wars between hospitals to conduct services. This strategy is designed to promote the consolidation of efficiency of services, which has lead to the regionalization of services, or the focusing of specialties in one location.
2. The digital revolution
The main impact of the digital revolution is that we now we have inexpensive access to computing power, allowing us to measure outcomes and appropriateness. And because we now live in a world of evidence-based medicine, we can make better decisions thanks to our ability to analyse data.
3. Patient expectations
The baby boomers who are now invading the healthcare system have high expectations—they want speed, quality, appropriateness and health information. And given that the healthcare system was not designed to treat chronic illness, the increase in non life-threatening procedures is transforming how healthcare works, and as a result, wait times are on the rise.
Wild variations in government spending—whether it is large influxes of cash or huge cutbacks—make it difficult to run a healthcare system with consistency.
Life expectancy has expanded more in the last 40 years worldwide than it has in the previous 2000 years. Life expectancy in the 1920s was 55 years of age; in the 1950s it was 65 years of age and now it’s 80 years and rising. We are indeed living longer, but we are also living with more chronic diseases, which places a large burden on the system.
Optimistic about the future
Mr. Decter firmly believes that innovation is what makes our system sustainable—however, the caveat is that we must convince governments, especially in times of economic downturn, to continue investing in innovation in order to save money on the front lines – in the hospital emergency rooms and on the wards
In times of economic uncertainty, governments tend to want to do “less of the same” and usually the first budget that goes on the chopping block is investment in innovation. Modern diagnostics (MRIs, scanners) are expensive on a per scan basis, but are less costly to the system over the long term.
What can the pharmaceutical industry bring to the table in terms of improving the state of our healthcare system?
The solution lies not in building more hospitals, or hiring more nurses and doctors, or investing millions in home care necessarily, but the key to success lies in innovation and in effective and efficient chronic disease management.
Small Dog Communications
Time: 5:30 p.m.