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Common Challenges

Common Challenges. US and Canadian Health Care CSG – ERC August 9, 2011. US Health System Accident of History. Early US Veteran’s support 1930’s Veteran’s Administration 1940’s Employer Sponsored Insurance 1965 Medicare – over 65 Medicaid – low income

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Common Challenges

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  1. Common Challenges US and Canadian Health Care CSG – ERC August 9, 2011

  2. US Health SystemAccident of History • Early US Veteran’s support • 1930’s Veteran’s Administration • 1940’s Employer Sponsored Insurance • 1965 Medicare – over 65 Medicaid – low income • 1997 Children’s Health Insurance (CHIP) • 2010 Affordable Care Act

  3. Our Hodgepodge System • Costs more than other OECD countries • Doesn’t cover everybody • Far from seamless • Dismantling 80 years of a piecemeal policy approach tremendous challenge

  4. International Comparison of Spending on Health, 1980–2008 Average spending on healthper capita ($US PPP) Total expenditures on healthas percent of GDP Source: OECD Health Data 2010 (June 2010).

  5. Life Expectancy at Birth, 2007 Years * 2006 ** 2005 Source: OECD Health Data 2009 (June 2009).

  6. Balancing Needs and Viewpoints QUALITY Purchasers Patients ACCESS COST Providers Payers Policymakers

  7. Canada 34 million 68% 15 – 64 16% over 65 81 – life expectancy @birth 81% population urban Source CIA World Factbook United States 313 million 67% 15 – 64 13% over 65 78 – life expectancy @ birth 82% population urban Let’s Look at Ourselves

  8. Out-of-Pocket Spending of $1,000 or More in the Past Year, by Income (Adjusted) percent Note: Percentages adjusted based on logistic regression to control for health status, age, and—in the U.S.—insurance status. * Indicates significant within-country differences with below-average income (p < 0.05). Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.

  9. Challenges • Changing demographics • Cost • Workforce • Improving delivery of care

  10. Changing demographics • Ethnicity • Age • Languages spoken • Generations • Attracting workforce to deliver care to changing demographics

  11. Cost CHALLENGES Aging Boomers will drive volume regardless of financing approach “80/20 rule” – lifestyle choices and chronic conditions Fragmented care Inefficient care – duplication etc.

  12. Workforce • AAMC projects 91,500 shortage of physicians by 2020; nearly half primary care • Health professionals are aging too! • Supply and distribution problems • BLS March 2011 healthcare sector added 37,000 new jobs – largest increase in any employment sector

  13. Looking Ahead - US • Patient Centered Medical Home • Payment Reform • Scope of Practice • Accountable Care Organizations • Team approach – best care, less spending • Evidence based medicine • Technology • health information exchanges and electronic medical records • Incentives – Loan Repayment

  14. CONTACT INFORMATION Paula K. Roy Executive Director Delaware Health Care Commission Margaret O’Neil Building 410 Federal St. Suite 7 Dover, DE 19901 302-739-2730 302-739-6927 fax Paula.roy@state.de.us www.dhcc.delaware.gov

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