No one will be surprised to be told that more investment is required in healthcare all while public, private and personal spending on health is at an all-time high. Historically, governments increase healthcare funding at an average rate of 2 to 4% per year. The graph below illustrates healthcare funding growth over the past two decades in current $ and in 1997-reference $ as a comparable. Over 264B$ is now spent on healthcare on a yearly basis in Canada, which represents an average of more than 7000$ per Canadian, for all Canadians; sick or not. But more is needed… Even though an obvious case can be made to keep the healthcare investment growing, there comes a point at which our society might be justified in wondering if there is such a thing as “too much”. If we answer yes, then how much is too much?
Actually, perhaps the question of “how much is too much” investment in healthcare is not the right one. One might argue that ensuring return on investment by identifying high impact targets is more important than trying to determine a threshold of funding beyond which it is too much. So, it may be better to ask: Which investments are the most promising ones? What is the wisest way to improve our health system in order to ensure its sustainability in providing quality care to all?
If we look at the breakdown of healthcare spending in the chart above, it is pretty clear that looking at wise investments for the population above 55 years of age is one important source of high impact investments. The bulk of healthcare expenditures is focused on that age group. So, low hanging fruit(s) for wise investments would have to be found for that segment of the population. One might say that it is fairly easy to come to that conclusion. Okay, I’ll give it to you: it’s a given that more investment is required in elder care… But the dilemma of scarce resources still stands. What should the specific investment targets be? What would yield the best return on investment? Those are questions still open for debate. In order to help us identify the right targets, learning from what is being done elsewhere is often times useful.
Denmark’s health system, which is often referred to as a model, successfully targeted homecare as a key healthcare investment. This approach enabled the system to introduce market dynamics in offering homecare services based on users’ preferences, which helped boost quality and reduce cost. It also lowered the need for long-term care services up to a point where no new long-term care facilities were built since the late 80’s. In 2019, Denmark’s long-standing success with its homecare approach became the springboard for a modernized, full-fledged vision that leverages 21st century technologies and prepares the country to face aging demographic trends. Perhaps a similar approach can be customized for Canadian health systems? It makes sense.
As our population ages and lives longer, maintaining people’s autonomy and capacity to remain living at home may not only yield best results for their health and well-being but also keep health costs under control as staying home with homecare services is less costly than more acute or long-term care. It is a win-win situation. Valuing and developing homecare seems to be one very promising way to strengthen the system through wise investments. More ideas will be necessary as we increasingly face the challenge of deciding where to invest scarce resources. If you were the ones deciding, where would you invest? Write to me with your ideas at blogbenoitmorin@gmail.com. I am sure there are many other good investments and your ideas will be good ones for future articles…
In the meantime, may you be well, may you be happy.
B.