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Addressing Challenges in US and Canadian Health Care Systems

Explore the common challenges faced by US and Canadian health care systems, including cost, access, quality, and workforce shortages. Learn about demographic shifts, rising costs, fragmented care, and strategies for improving health care delivery.

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Addressing Challenges in US and Canadian Health Care Systems

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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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