Is health always local? We typically assume that health is always a domestic issue—that is, we tend to focus on the health of a community or a state, but rarely internationally—but if we just keep looking inward, we could lose out on some valuable lessons. Take the example of William Osler, one of the four founding physicians of Johns Hopkins University School of Medicine. Patient interaction was fundamental to Osler's teachings. He once said, "Listen to your patient, he is telling you the diagnosis."
Osler was Canadian, and while at Hopkins, he revolutionized the teaching of medicine in both the United States and Canada by adapting features of the English and German systems. Osler combined American egalitarian principles with the English system by teaching all medical students at the bedside. Osler's contributions help remind us about our common values and how they can be used to improve the lives of patients.
Historically, the close friendship between the United States and Canada has helped achieve a vast number of joint goals, whether it be through trade, security, or energy. But when it comes to health, the common perception is that our systems are too different, solely because of how they differ on financing. But focusing solely on "who pays" causes us to ignore similarities such as an aging population, workforce shortages, a need to be able to "scale up" local innovations, and a shared desire for a more efficient, value-based reimbursement system.
In fact, according to an analysis of eleven industrialized nations, which was published by the Commonwealth Fund in 2014, Canada and the United States rank at the bottom—tenth and eleventh, respectively—in health system performance. That same report noted that the two nations both ranked poorly on access and efficiency. The United States ranked higher than its northern neighbor on quality of care, while Canada ranked slightly better than the United States on equity and "healthy lives" indicators. Moreover, Canadians spend much less ($4,522) than Americans do ($8,508) annually per capita for roughly the same outcomes. Clearly, both countries could learn from each other—and other industrialized nations—how to improve the efficiency and effectiveness of their health care systems.
Taking a page from Osler, we feel that there is much that Canada and the United States can learn from each other. Each of our health systems is going through rapid, transformational change, and ten years from now, health care delivery will have evolved significantly in both countries, not to mention health will have changed because of the impact of big data, technological advances, and an aging population. Of course, there are several health areas where we do already collaborate! At both the federal and the state/provincial levels, regulatory and surveillance systems are communicating with one another, on a frequent basis, for public health purposes.
How can we harness the talent in both nations to address the massive challenges ahead? For us, it was bringing together diverse voices to begin a dialogue on health policy. In November 2015 we convened a summit at the Woodrow Wilson International Center for Scholars to bring together government officials, academics, and stakeholders from both Canada and the United States to think about health and health care. To support this goal of a policy dialogue between the two nations, the Robert Wood Johnson Foundation provided substantial funding with additional support provided by GS1 Canada, Dun & Bradstreet, and Medtronic. (Notably, the Robert Wood Johnson Foundation released a subsequent request for proposals on adapting from other nations.)
Participants at the summit engaged in lively, provocative discussions around delivery system reform, health information technology (IT) implementation, measurement of quality of care, consumer engagement, and other topics related to areas of cooperation. Our keynote speaker, former US Secretary of Health and Human Services (HHS) Kathleen Sebelius noted that even before she had been confirmed, she was already working with her Canadian counterpart to respond to the H1N1 influenza pandemic. This collaboration became the foundation for future public health partnerships.
One challenge that we could not predict is where the health care landscape will change because of electoral politics: the summit occurred just days before the Canadian election and a year before the 2016 American elections.
We believe the summit helped exchange valuable learnings, while highlighting areas where the two countries currently collaborate and also where they could collaborate to improve health. And thanks to the generous support from the Robert Wood Johnson Foundation, we are pleased to release our summary report, which suggests areas for future exploration and collaboration that were identified by our expert panels. Additionally, in the report we identify several compelling stories of health care leadership from each nation.
But it is just a first step for us as the conference only scratched the surface of what can be accomplished. To further this dialogue, we have established Cross-Border Health, which will provide a forum for health leaders in Canada and the United States—and perhaps other nations in the future—to exchange ideas and collaborate on common priorities in health. We will be engaging with our stakeholders to drill down on several of these areas in 2016.
As our conference clearly demonstrated, the United States and Canada—as well as many other nations—share common challenges and the same goal of wanting to provide better health care value and create a culture of health. By establishing a conversation that will last beyond our initial summit, we ultimately want to make our nations healthier and our health systems operate better.
from Health Affairs Blog http://ift.tt/25jQZUb
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