Most of us are aware that the population is aging and the effects this has on the healthcare system.
By Roderick A. Slavcev, Ph.D., MBA, MRSB, C.Biol.
Illustration by Martin Bregman
But few stakeholders truly understand the magnitude of the economic impacts and threats to sustainability brought on by this change.
Taking into account birth, death, and net migration statistics, projections predict that nearly one-quarter of the population will be 65 years or older just two decades from now. Worse yet, this aging demographic will be met with a 10% reduction in the workforce, compounding the problem even further (Statistics Canada, 2011; Canadian Institutes for Health Information, 2011).
To get a grasp on this staggering issue, if spending continues unabated over just the next few years, government healthcare spending may equal 100% of total revenue in the majority of Canadian provinces (Skinner, B.J. and M. Rovere, 2006. Paying More, Getting Less 2006: Measuring the Sustainability of Public Health Insurance in Canada, Vancouver, BC: Fraser Institute) – no roads, schools, social programs, nothing! Projections show that costs will finally outpace revenues, decreeing the unsustainability of our universal healthcare system.
At present Canada spends about 11% of its gross domestic product (GDP) on healthcare, or $213 billion last year (Drug Expenditure in Canada, 2011. Canadian Institute for Health Information (2014 updated), which may seem cheap compared to our southern neighbour, who allocates closer to 18%, but it’s not about cost, but cost-benefit. What do we get for the money spent? At present the World Health Organization (WHO) estimates that wastage due to inefficiency in healthcare ranges from 20 to 40%, which translated to as much as $85 billion in 2015 (World Health Report 2000. Health Systems: Improving Performance, Geneva, Switzerland: World Health Organization).
In Canada we agree that access to healthcare is a right of every citizen, but this promise now teeters dangerously close to extinction due to the system’s inability to sustain itself…but why is that? Previous attempts at healthcare reform, while perhaps noble in vision and pursuit, continue to be mired in the self-protective and non-competitive nature of a system itself that supports all suppliers in the public system.
I feel that solutions may only emerge from a guiding paradigm shift in philosophy and vision. This is a term I’ve coined: New Pharmacy…a value-driven approach to the provision of healthcare, where pharmacy holds the key to reforming healthcare into a sustainable system. And did I mention it’s extremely lucrative?
New Pharmacy comprises an iterative value-driven concept of healthcare delivery that focuses outward on the patient/customer, rather than inward on the supplier – a concept that although seemingly obvious and basically rooted in strategic management, has not yet proven possible.
The reason is quite simple and based in economic theory. Our healthcare system is driven by supply rather than demand, and it’s trapped in an approach of acute service provision despite the growing need for chronic healthcare by almost half of our population. Healthcare providers and other access points operate in silos and are economically incentivized in different ways. No one access point focuses on the patient, despite buzzwords like “patient-centred/focused care,” because, quite simply, no one is paid based on successful patient outcomes – a case of a massive misalignment of incentives.
I have taken the principles of value-driven pharmacy and have crafted a model that I strongly believe will lead to the reorganization of healthcare in Canada with pharmacists at the helm…that is, if you’re willing to learn the management and leadership skills to deliver it.
As I’ve stated many times, I’m not interested in fixing the pharmacy industry. NuRx will fix healthcare, employing pharmacy as the disruptive innovation technology to do so. This solution enacts business skills to extract the untapped value within each pharmacist through a model that will revolutionize and sustain healthcare, Canada’s most prized and defining accomplishment.
Interested? If so, learn more in the next issue.
Roderick A. Slavcev, Ph.D., MBA, MRSB, C.Biol. is Associate Professor, Pharmaceutical Sciences, & Professor of Business and Entrepreneurship, University of Waterloo