Health care in Canada is running a deficit in more ways than just the fiscal side, according to the Conference Board of Canada.
The deficit in performance comes from a 1960s model of system management, ill-defined goals, and an ideological, values-driven debate dominated by vested interests, rather than a dialogue - that includes patients - about the best ways to provide health services, the board states in a press release.
The Conference Board's recent Summit on Sustainable Health and Health Care - featuring some of the leading thinkers in Canada - highlighted the need for transformation in the health care system. The post-Summit report, The Inconvenient Truths About Canadian Health Care, identifies five priorities for reform.
"The evidence is strongly mounting that we are incorrect in believing that we have the best health care system in the world from the perspective of relative effectiveness and efficiency of the services provided," said Daniel Muzyka, president and CEO of the Conference Board and co-author of the publication.
"A number of issues clearly articulated and shared during the Summit, fueled by an aging population and internal cost pressures, make it clear that we have to face some 'inconvenient truths' when it comes to health care."
For years, The Conference Board of Canada has given a "B" to Canada's health care system, most recently ranking it 10th out of 17 countries in the 2012 How Canada Performs report card. Other analyses have shown Canada has comparatively high spending, but modest health outcomes.
As one summit participant noted, pouring more resources into a system that isn't configured to achieve the outcomes society wishes, and doesn't necessarily focus on the drivers of health and wellness, is like "pouring water into sand."
The Conference Board identifies five priorities to spur health care transformation:
Fix the gateway to the health care system. Primary care, not the emergency room, should be the first contact point within the health care system and the key access point for other health-related services. There was a strong consensus that interdisciplinary family care teams should be the standard model for primary care.
Invest in and use technology in the health care system, particularly information and communication technology. More intensive and standardized use of information technology will allow patient information to be collected and shared seamlessly, making treatment more effective (better outcomes and fewer errors) as well as efficient - thereby boosting the productivity of the system overall.
Change the compensation system and related labour contracts for health care professionals. Compensation models need be linked more to patient and community health care outcomes and less to activities such as treatment and consultation.
Focus on the state of the health and wellness of Canadians overall. A healthy population should be our goal. A healthy population will demand fewer acute care services caused by preventable chronic diseases.
Build a more transparent and accountable health care system with respect to goals, management, and performance.
These reports are part of the research program of the Conference Board's Canadian Alliance for Sustainable Health Care (CASHC). Launched in 2011, CASHC is a five-year Conference Board program of research and dialogue. It will delve deeply into facets of Canada's health care challenge, including the financial, workplace, and institutional dimensions, in an effort to develop forward-looking qualitative and quantitative analysis and solutions to make the system more sustainable.
