Health Care Sustainability More Than a Fiscal Matter

Ottawa, July 15, 2014—Rising health care costs, which currently account for almost half of provincial budgets, threaten the future of our health care system. But they are not the only threat to sustainability. Doctor and nurse shortages, low productivity in some areas, safety of services provided, and Canadians’ decreasing trust and confidence are among some of the issues affecting health care.

A new Conference Board of Canada report, Defining Health and Health Care Sustainability,stresses that finding solutions to health care sustainability requires more than increased funding or fiscal restraint—it requires a multi-faceted, systemic approach.

“Health care sustainability is a complex issue that goes beyond affordability,” said Louis Thériault, Executive Director of the Conference Board’s Canadian Alliance for Sustainable Health Care. “It is more about improvement and innovation than the status quo, and it requires flexibility and creativity to adapt to changes in demand.”

Highlights

• Sustaining health and health care requires a multi-faceted approach that goes far beyond decisions about how much money to spend.
• Shortages of medical professionals, low productivity in some areas, safety issues and decreasing trust also threaten sustainability.
• Four principles should guide sustainability strategies: accountability for results, value for money, fair and timely access, and appropriateness.

The report, published under the Conference Board’s Canadian Alliance for Sustainable Health Care (CASHC) offers a definition of sustainable health and health care that is being used to guide CASHC’s policy work and future recommendations regarding the health of Canadians and the organization of the health care system.

Sustainable health and health care is defined as the appropriate balance between the cultural, social, and economic environments designed to meet the health and health care needs of individuals and the population and that leads to optimal health and health care outcomes without compromising the outcomes and ability of future generations to meet their own health and health care needs.

The report also provides a framework to think about, understand and approach sustainability. It includes four guiding principles and six key factors that are essential to support sustainable health care in Canada. These sustainability measures should be implemented across the continuum of care, across diseases, and across government departments in order to create a well-functioning health care system.

Guiding principles

• Accountability for results—ensures action on the different factors that affect health care sustainability and drives improvements in performance.
• Value for money—ensures that better outcomes are attained for similar investment levels. It prompts elimination of waste, efficiency gains, and stimulates innovation.
• Fair and timely access—lack of fair and timely access affects the health of the population and undermines public confidence in the system.
• Appropriateness—ensures best resources are used at the best time to deliver the services that will lead to the best health outcomes.

Key factors

• Effective disease prevention and health promotion
• Effective health and health care systems
• Funding models that drive desired behavioural change
• Leveraging innovation and innovative technologies
• Optimal development alignment, and support of human resources
• Strategic alignment with determinants of health

Launched in 2011, CASHC is a program of research and dialogue, investigating various aspects 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 sustainable.