The New Brunswick Situation What is the provincial government proposing? 1.

The New Brunswick SituationThe New Brunswick SituationWhat is the provincial

government proposing?

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Provincial Plan 2013-2018

• September 2013: Government of New Brunswick releases the Provincial Health Plan, “Rebuilding Health Care Together – A Blueprint for Sustainability”.

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A Blueprint for Sustainability• Aspires to broad principles, but lacks detail.

• It is “government’s…vision of a stronger economy and an enhanced quality of life while living within our means”.

• Focus is short-term finances, rather than population health outcomes and long-term sustainability.

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Fiscal Focus• What are the claims?– Universal Public Health

Care is too expensive.

– Spending is out of control and a burden on taxpayers.

– Healthcare spending has minimal impact on health outcomes.

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Where does this lead?• Principles for Rebuilding

– Quality = high volume hospitals.

– Efficiency = reduction of human and financial resources.

– Access = travelling to receive services.

– Clinical Sustainability = minimal coverage of services

through “clustering”.

• Benchmarking to national averages to justify cuts.

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Office of Health System Renewal – Benchmarking and Performance Improvement Project

• Late 2012: private consulting firm hired to conduct benchmarking exercise.

• 3 areas identified for performance improvement:– Improved productivity– Reduced length of hospital stay– Reduction in hospitalization

• Report data primarily financial. • Bulk of targeted savings fall under improved productivity;

through reduction of hours worked by both clinical and administrative staff.

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Concerns• Demographic and soci-economic factors in NB lead to justifiably

higher cost of delivering healthcare.

“Using Actuarial Modelling to Unravel the Trends in Healthcare Costs in New Brunswick”, John Have, 2013

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LifestyleCanada (% of population)

New Brunswick (% of population)

5+ alcohol drinks at least once per month

17.3 20.0

Smoker, daily or occasionally

21.3 23.0

BMI>30 17.1 24.2

Concerns (Cont’d)• Current economic considerations

are short-sighted and miss opportunities for long term savings.

• Reorganization of NB healthcare system being lead by engineering, accounting and business professionals and a private for profit agency, rather than healthcare professionals and public servants.

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BibliographyCanadian Cancer Society’s Steering Committee. (April 2010) “Canadian Cancer Statistics 2010” Toronto: Canadian Cancer Society, 2010. Editorial Board. (2009) “Tracking Heart Disease & Stroke in Canada” Public Health Agency of Canada, available on Internet at the following address: www.phac-aspc.gc.ca Have, John. (2013) “Using Actuarial Modelling to Unravel the Trends in Healthcare Costs in New Brunswick” Canadian Institute of Actuaries. Hura, Adam. (July 18, 2013) “MP Backs Health Transfer Changes” Telegraph Journal. Horizon Health Network (April, 2013) “Horizon Health Network and the Performance excellence Process” Fredericton: Horizon Health Network. MacKenzie, Hugh & Rachlis, Michael (2010) “The Sustainability of Medicare” Ottawa: The Canadian Federation of Nurses Unions.

New Brunswick Medical Society (2013) “Care First: Fixing New Brunswick’s Healthcare System. New Brunswick Doctors Have a Plan” Fredericton: New Brunswick Medical Society.

Province of New Brunswick (2013) “rebuilding Health Care Together: The Provincial Health Plan 2013-2018 - A Blueprint for Sustainability” Fredericton: Province of New Brunswick. Raymond Chabot Grant Thornton (April 25, 2013) “Office of Health System Renewal Benchmarking and Performance Improvement Project, Final Report, Phase 1 – Benchmarking” Office of Health System Renewal, available at the following address: http://www.gnb.ca/0212/values/pdf/OHSR%20Phase%201%20Final%20Report%2025-04-2013.pdf Statistics Canada (2012) “Proportion of the population living in rural areas, provinces and territories, 2006 and 2011” Statistics Canada, available at the following address: http://www12.statcan.gc.ca/census-recensement/2011/as-sa/98-310-x/2011003/fig/fig3_2-3-eng.cfm

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