91³Ō¹Ļ

91³Ō¹Ļ experts on why itā€™s time to fix medicareā€™s innovation problem

Photo of hospital
How Canada finances and delivers health care hasnā€™t changed much in 50 years, focusing on hospitals and doctors (photo by Christopher Furlong/Getty Images)

Canadians like to compare our health-care system to that of the U.S., but they should look further afield: They will discover other countries provide universal coverage that is more comprehensive, has better wait times and costs less,

 ā€œWeā€™re laggards when it comes to innovation, and the architecture of our system needs to evolve rapidly,ā€ write Dr. Andrew Boozary, a resident family physician at 91³Ō¹Ļ, and Dr. David Naylor, 91³Ō¹Ļā€™s president emeritus and a professor of medicine. Naylor led , which calls for a $1.3-billion increase in federal research funding over four years, as well as sweeping changes to how it is administered.

In the op-ed, Boozary and Naylor argue that how Canada finances and delivers health care hasnā€™t changed much in 50 years, focusing on hospitals and doctors. Funding of the system needs to be more integrated, they say.

ā€œFor example, insuring physiotherapy services provided in clinics or at home might save costs by reducing return visits to doctors or days in hospital,ā€ they write. ā€œThereā€™s just no way to make that math work, or take other innovative steps, when each part of the system has a separate budget.ā€

Boozary and Naylor urge Canada to adopt an approach advocated by the Center for Medicare and Medicaid Innovation (CMMI), a U.S. hub that focuses on integrating payments around the patient.

ā€œCMMI is the source of ideas like bundling all payments to hospitals and professionals alike when financing complex services that bridge hospitals and homes, like hip replacements,ā€ they write.

An important part of CMMI is how it evaluates innovation, they write. ā€œIf something works, CMMI makes that payment option widely available. If it doesnā€™t, the model is tweaked and re-evaluated.ā€

Their conclusion: The hard reality ā€“ reinforced by multiple performance indicators and countless stories from frustrated patients and professionals ā€“ is that we just canā€™t keep delivering health care as we always have."

 

  

 

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