28 november 2000 33rd annual canadian employee benefits conference ambrose m. hearn, che ceo, von...

28 November 200033rd Annual Canadian Employee Benefits

ConferenceAmbrose M. Hearn, CHE

CEO, VON Canada

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NATIONAL VIEWOF AN

AGING POPULATION

BRIDGE TO A SOLID FUTURE



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NATIONAL VIEW ON ANNATIONAL VIEW ON ANAGING POPULATIONAGING POPULATION

• Changing Society

• Values and Beliefs

• Aging

• Health

• Wealth



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• Population of Canada

• Health System in Canada

• The Impact of an Aging Population on the Health

System

• What about the Future?

• What should we do?

NATIONAL VIEW ON ANAGING POPULATION



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• Population of Canada

Changes over Time

Regional Issues

Immigration

Emigration



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• Population Aging in Canada

Life Expectancy and Mortality Rates

Fertility Rates

Morbidity

Economic and Societal Conditions



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• Life Expectancy and Mortality Rates

Major Improvement over the past 70 years

• 20 years for Women

• 15 years for Men



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Women:Life expectancygiven selectedages, 1926 to 1996



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Men:Life expectancy given selected ages, 1926 to 1996.



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• Life Expectancy and Mortality Rates Prior to 1966

• Infections

• Respiratory Illness

• Diseases of the Digestive Tract

• Complications of Childbirth



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After 1966

• Diseases of Circulatory System

• Accidents

• Poisonings

• Violence



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Reasons for Improvement

• Medical Technology

• Medical and Scientific Research

• Drugs



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• Life Expectancy and Mortality Rates Reasons for Improvement

• Rise in Living Standards

• Sanitation

• Immunization

• Nutrition

• Safety Standards



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What about the future?

Significant gains much less likely

Eliminate all causes of death except Cancer and Circulatory System Diseases

• Increase life expectancy by 5 years



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• Fertility Rates

Mini “Baby Boom” in the 1920’s

Major “Baby Boom” following WW II



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• Fertility Rates

Mini Boom 1920’s

• Accounts for increase in population over 75 in

recent years

• Wave of immigration after WW II of people born

elsewhere in 1920’s



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• Fertility Rates

Major Boom following WW II

• Will reach 65+ around 2010

• Has had major impact on Society– Health Care System– Schools – Work



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Fertility Effect



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Decomposition ofaverage annualgrowth in realper capita healthexpenditure



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Health Expenditures 1998-99



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• Fertility Rates

Temporary but significant impact on Population

• Public Expenditures

• Societal Values and Policies

Current Situation



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• Morbidity (Incidence of Disease)

Years of Life (Healthy ---- Unhealthy)

Quality of Life

Health Care Costs



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• Morbidity Chronic Diseases

• Early Diagnosis

• Medical Technology

• Medical Knowledge

• Co-ordination of follow-up care



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The Survival Curve



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Health-AdjustedLife Expectancy



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• Morbidity ---- Conclusion

Early Diagnosis of Chronic Conditions

An increased number of ( healthy/ unhealthy)

years

Quality of Life

Greater Costs to Society



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• Economic and Societal Conditions

Greater Disparity

Shift to Right

Changing Values

Increased Tensions



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• Health Care Providers (Physicians Nurses)

Aging

Supply

Availability

Implications for the Future



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• Health Care System in Canada

Post World War II

Hospitals

Nursing Homes

Human Resources (Physicians, Nurses, Technologists)



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Home Care

Pharmaceuticals

Medical Services

Natural Therapies



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Friday 24 November 2000 -- The Ottawa Citizen

Our health system is such a mess I had to go to the United States



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A System in Change ---- A System in Crisis

• Organization Realignment

• Primary Care

• Home Care and Pharmaceuticals

• Physicians, Nurses and Other Care Givers



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What can we expect now?

• Hospitals

• Nursing Homes

• Home Care



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Care in the Home

Caregiving and Caregivers




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• What happened in Home Care

An Explosion of Home Care and Home

Support Programs




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• Governments --- Provincial

Each Province Developed Independently

Organizational Chaos --- Social --- Health

Cost Savings --- Cost Shifting




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• Governments --- Provincial

Unclear Policies --- Non Policies

Public Health Nursing --- Decline

Quality




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• Care in the Community Now --- New Frontier

No Clear Rules

Rapid Change

Inconsistent Behaviours

Anything is Possible

Nothing Seems Possible




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• Society --- What is Expected?

Services to be Available

Equality of Treatment

Balance the System

Quality Care and Services

A Program like Hospitals and Medicare




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• Community --- What Has Been Occurring?

Rapid Expansion of Services --- Nursing and

Home Support

New Technologies

More Complex Cases

Sicker Patients




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• Community (Cont’d)

Wage Disparities

Managed Competition

More Government Administrators

Continuous Public Debate




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• Provider Organizations

Not for Profit and For Profit --- Community

Hospitals

Regional Authorities

Community Health Corporations




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• Who Provides Care in the Home

Nurses and Therapists

Unregulated Workers --- Home Support

Without Universally Approved Standards

Often Minimal Supervision




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• Characteristics of Formal Providers

Mainly Women

Wage Disparities

Benefits Disparities

Training Gaps

Differentiated Working Conditions




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• Characteristics of Informal Caregivers

Mainly Women

Family Members and Friends

Greater Incidence of Sickness

Little Training and Support

Lost Incomes




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• What about the Future

Impact to be felt in Health system

• Hospitals

• Nursing Homes

• Home Care



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• What about the Future

Pressure for Government

Pressure for Benefit Plans

Challenge to Society



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• What Should We Do?

Look for innovative ways to respond to needs

Make representation to Governments to

continue to change the system

Recognize the funding requirements and set

aside funds to accommodate needs



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Look for innovative ways to respond to needs

• Reform of Primary Care

• Integration of Health Services

• Develop new Models of delivery



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Make representation to Governments to

continue to change the system

• Provincial Governments

• Federal Government

• Joint Federal/Provincial



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• What Should We Do? Recognize the funding requirements and set

aside funds to accommodate needs

• Establish Reserves to respond to known needs

• Develop alternative methods of funding service

• Introduce financial incentives to reduce use



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• In Summary ---- Impact of Aging Population on Health System

We will live longer but more years of unhealthy life

means higher costs

Higher costs during last days of life

Major temporary effect of Baby Boom

Tremendous Pressure on Society



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Final Thoughts



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Thank you for your attention.

Good Luck

28 november 2000 33rd annual canadian employee benefits conference ambrose m. hearn, che ceo, von...

Documents

aging population slide

che ceo

national view

aging population women

aging population men

canada life expectancy

aging population bridge

mortality rates reasons