 Extracts from the Arcus Healthcare 2020 report
Spending on physicians is growing faster than spending on hospitals or drugs
Hospitals continue to account for the largest component of Canada’s health care spending; however, their share of total health expenditure steadily declined over the past three decades. In 2009, hospitals are expected to account for 27.8% ($51.0 billion) of total health care spending, down from 44.7% in 1975. In 2009, spending on drugs (including both prescribed and non-prescribed medications) made up the second-largest proportion of health dollars, accounting for an estimated 16.4% ($30.0 billion) of the total.
This share nearly doubled over the past 30 years and has remained stable since 2007 (16.5% in 2007 and estimated 16.4% in 2008). Payments to physicians represent Canada’s third-largest share of health expenditure, accounting for an estimated 14.0% of total spending in 2009 ($25.6 billion), a share that has remained relatively stable since 1998. Spending on physicians is expected to grow at an estimated annual growth rate of 8.8% this year. This is higher than the forecast growth rates for hospitals and drugs, which are each estimated to grow by 5.1%.
Healthcare 2.0 will drive Digital Medicine and Delivery Systems
While Canadian healthcare policy may currently be dependent on politicians, an emerging theme is how Internet technology, specifically Web/Health 2.0, can facilitate innovation and communication within the healthcare sector, and what the challenges and long-term implications of this might be. There are new ways Web/Health 2.0 is being used as a tool for innovation in Digital Medicine and Delivery Systems.
According to Arcus research, 8 million Canadians are Health 2.0 users and fall within the 18-34 age demographic, compared with 3m-4m users in 2007. The Arcus study also found that the younger a user was, the higher the likelihood of going online for healthcare research. A growing divide is the slow pace at which doctors are embracing the medium. The number of people going online to search for health and pharmaceutical information is growing and this demand has yet to be fully addressed. Currently, there has not been enough investment in Web 2.0 from the largest pharmaceutical or medical equipment companies. Once one or two of the majors does begin to invest however, others are expected to follow suit.
For example, connectivity and community are key components of the growing population of cancer patients using innovative resources to take more of an empowered role in their condition and treatment management. According to the 2010 Arcus Healthcare 2.0 study, more than sixty percent of cancer patients are eHealth Consumers, reporting to go online for health information.
While cancer patients report to use online health and pharmaceutical resources along all points of the disease continuum, they are most likely to rely on the Internet right after receiving a diagnosis from their physician. Cancer patients are also more avid users of health-related social media than age would predict. This condition group tends to be more comfortable with sharing information and resources than other types of patients - eHealth cancer patients are twice as likely as the average eHealth Consumer to post health content online. Several health organizations and pharmaceutical companies have taken notice of this community’s interest in connecting and sharing online and launched social media initiatives. Globally, there are advances being made in this area. The American Cancer Society offers a virtual network for cancer patients, caregivers, survivors, and information-seekers, while Genentech BioOncology sponsors the Herceptin HER Story Community specifically for HER2+ breast cancer patients.
A shift from treatment of medical problems to disease prevention
At present, our system emphasizes treatment of medical problems, rather than on disease prevention. Healthcare in Canada is an issue that has been hotly debated by both governments and Canadians. At present, our system emphasizes treatment of medical problems, rather than on disease prevention and health maintenance.
This system, however, is very expensive; producing cost increases in healthcare that are well above the average increases in income. While this debate continues, other trends in health care are becoming apparent. For one thing, there will be a growing market for products and services that promote good health. In addition, there is an increasing demand for medical products and procedures that will enable us to look younger. Poor nutritional habits have plagued Canadians for the past several decades, and have resulted in a significant increase in obesity; especially among children.
Another growing trend has been on the increased reliance of cosmetic surgery in improving one's physical appearance. Services for healthy living will be in greater demand as Baby Boomers and Generation X members grow older. As life expectancy increases, the demand for nursing and rehabilitation services will continue to grow. The nursing shortage that already exists is expected to worsen in the next twenty years.
There are additional concerns regarding the declining number of physicians. The majority are currently in their forties and fifties, so many will retire by the year 2030. Future trends, however, will depend heavily on changes that may occur in the health industry, and whether a stronger emphasis will be place on health maintenance and disease prevention. They will also depend on government policies.
Canadians are healthier today - a drop in the number of people dying from catastrophic disease
The chart shows a snapshot of Canada’s health performance on the 11 indicators relative to the best-performing country for each decade. It has 11 axes—one for each indicator—that radiate out from the centre. A score closer to the centre represents worse performance, while a score closer to the outer circle represents better performance. On balance, fewer Canadians are dying today from the diseases benchmarked here than they did in the 1960s and 1970s. Clearly, progress is being made in reducing the number of people dying from catastrophic disease. Relative to its peers, however, Canada dropped to 10th place in the most recent year of data—down from a much more envious 5th place in the 1990s.
Canada has not made progress on all indicators. The mortality rate due to misadventures during medical care is higher now than it was in the early 1980s, and so Canada’s relative ranking on this indicator has dropped from an “A” in the 1990s to a “B” this decade. However, this increase might be due to increased reporting of misadventures resulting from greater awareness of the importance of reporting and the availability of better tracking systems that have been generated by recent patient safety movements.
More also needs to be done to combat diabetes, which now affects more than 2 million Canadians (or 1 in 11 adults). The Diabetes in Canada Evaluation (DICE) study found that nearly half of diabetes patients do not have their blood sugar levels under control. The Health Council of Canada found that half of all family physicians are not well prepared to handle patients with multiple chronic health conditions.
In 2005, the federal government committed $300 million over five years to the Integrated Strategy on Healthy Living and Chronic Disease. Its target is a 20 per cent increase by 2015 in the number of Canadians who are physically active, follow healthy diets, and achieve a healthy body weight. With targets now set, governments and partner organizations need to devise mechanisms for tracking and reporting on progress toward the national targets.
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