28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 1 NATIONAL VIEW OF AN AGING POPULATION BRIDGE TO A SOLID FUTURE

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 2 NATIONAL VIEW ON AN AGING POPULATION Changing Society Values and Beliefs Aging Health Wealth

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 3 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 AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 4 NATIONAL VIEW ON AN AGING POPULATION Population of Canada  Changes over Time  Regional Issues  Immigration  Emigration

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 5 NATIONAL VIEW ON AN AGING POPULATION Population Aging in Canada  Life Expectancy and Mortality Rates  Fertility Rates  Morbidity  Economic and Societal Conditions

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 6 NATIONAL VIEW ON AN AGING POPULATION Life Expectancy and Mortality Rates  Major Improvement over the past 70 years 20 years for Women 15 years for Men

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 7 NATIONAL VIEW ON AN AGING POPULATION Women: Life expectancy given selected ages, 1926 to 1996

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 8 NATIONAL VIEW ON AN AGING POPULATION Men: Life expectancy given selected ages, 1926 to 1996.

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 9 NATIONAL VIEW ON AN AGING POPULATION Life Expectancy and Mortality Rates  Prior to 1966 Infections Respiratory Illness Diseases of the Digestive Tract Complications of Childbirth

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 10 NATIONAL VIEW ON AN AGING POPULATION Life Expectancy and Mortality Rates  After 1966 Diseases of Circulatory System Accidents Poisonings Violence

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 11 NATIONAL VIEW ON AN AGING POPULATION Life Expectancy and Mortality Rates  Reasons for Improvement Medical Technology Medical and Scientific Research Drugs

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 12 NATIONAL VIEW ON AN AGING POPULATION Life Expectancy and Mortality Rates  Reasons for Improvement Rise in Living Standards Sanitation Immunization Nutrition Safety Standards

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 13 NATIONAL VIEW ON AN AGING POPULATION Life Expectancy and Mortality Rates  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

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 14 NATIONAL VIEW ON AN AGING POPULATION Fertility Rates  Mini “Baby Boom” in the 1920’s  Major “Baby Boom” following WW II

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 15 NATIONAL VIEW ON AN AGING POPULATION 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

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 16 NATIONAL VIEW ON AN AGING POPULATION Fertility Rates  Major Boom following WW II Will reach 65+ around 2010 Has had major impact on Society –Health Care System –Schools –Work

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 17 NATIONAL VIEW ON AN AGING POPULATION Fertility Effect

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 18 NATIONAL VIEW ON AN AGING POPULATION Decomposition of average annual growth in real per capita health expenditure

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 19 NATIONAL VIEW ON AN AGING POPULATION Health Expenditures

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 20 NATIONAL VIEW ON AN AGING POPULATION Fertility Rates  Temporary but significant impact on Population Public Expenditures Societal Values and Policies  Current Situation

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 21 NATIONAL VIEW ON AN AGING POPULATION Morbidity (Incidence of Disease)  Years of Life (Healthy ---- Unhealthy)  Quality of Life  Health Care Costs

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 22 NATIONAL VIEW ON AN AGING POPULATION Morbidity  Chronic Diseases Early Diagnosis Medical Technology Medical Knowledge Co-ordination of follow-up care

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 23 NATIONAL VIEW ON AN AGING POPULATION The Survival Curve

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 24 NATIONAL VIEW ON AN AGING POPULATION Health-Adjusted Life Expectancy

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 25 NATIONAL VIEW ON AN AGING POPULATION Morbidity ---- Conclusion  Early Diagnosis of Chronic Conditions  An increased number of ( healthy/ unhealthy) years  Quality of Life  Greater Costs to Society

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 26 NATIONAL VIEW ON AN AGING POPULATION Economic and Societal Conditions  Greater Disparity  Shift to Right  Changing Values  Increased Tensions

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 27 NATIONAL VIEW ON AN AGING POPULATION Health Care Providers (Physicians Nurses)  Aging  Supply  Availability  Implications for the Future

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 28 NATIONAL VIEW ON AN AGING POPULATION Health Care System in Canada  Post World War II  Hospitals  Nursing Homes  Human Resources (Physicians, Nurses, Technologists)

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 29 NATIONAL VIEW ON AN AGING POPULATION Health Care System in Canada  Home Care  Pharmaceuticals  Medical Services  Natural Therapies

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 30 NATIONAL VIEW ON AN AGING POPULATION Friday 24 November The Ottawa Citizen Our health system is such a mess I had to go to the United States

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 31 NATIONAL VIEW ON AN AGING POPULATION Health Care System in Canada  A System in Change ---- A System in Crisis Organization Realignment Primary Care Home Care and Pharmaceuticals Physicians, Nurses and Other Care Givers

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 32 NATIONAL VIEW ON AN AGING POPULATION Health Care System in Canada  What can we expect now? Hospitals Nursing Homes Home Care

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 33 Care in the Home Caregiving and Caregivers NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 34 What happened in Home Care  An Explosion of Home Care and Home Support Programs NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 35 Governments --- Provincial  Each Province Developed Independently  Organizational Chaos --- Social --- Health  Cost Savings --- Cost Shifting NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 36 Governments --- Provincial  Unclear Policies --- Non Policies  Public Health Nursing --- Decline  Quality NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 37 Care in the Community Now --- New Frontier  No Clear Rules  Rapid Change  Inconsistent Behaviours  Anything is Possible  Nothing Seems Possible NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 38 Society --- What is Expected?  Services to be Available  Equality of Treatment  Balance the System  Quality Care and Services  A Program like Hospitals and Medicare NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 39

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 40

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 41

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 42

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 43 Community --- What Has Been Occurring?  Rapid Expansion of Services --- Nursing and Home Support  New Technologies  More Complex Cases  Sicker Patients NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 44 Community (Cont’d)  Wage Disparities  Managed Competition  More Government Administrators  Continuous Public Debate NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 45 Provider Organizations  Not for Profit and For Profit --- Community  Hospitals  Regional Authorities  Community Health Corporations NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 46 Who Provides Care in the Home  Nurses and Therapists  Unregulated Workers --- Home Support  Without Universally Approved Standards  Often Minimal Supervision NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 47 Characteristics of Formal Providers  Mainly Women  Wage Disparities  Benefits Disparities  Training Gaps  Differentiated Working Conditions NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 48 Characteristics of Informal Caregivers  Mainly Women  Family Members and Friends  Greater Incidence of Sickness  Little Training and Support  Lost Incomes NATIONAL VIEW ON AN AGING POPULATION

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 49 NATIONAL VIEW ON AN AGING POPULATION What about the Future  Impact to be felt in Health system Hospitals Nursing Homes Home Care

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 50 NATIONAL VIEW ON AN AGING POPULATION What about the Future  Pressure for Government  Pressure for Benefit Plans  Challenge to Society

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 51 NATIONAL VIEW ON AN AGING POPULATION 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

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 52 NATIONAL VIEW ON AN AGING POPULATION What Should We Do?  Look for innovative ways to respond to needs Reform of Primary Care Integration of Health Services Develop new Models of delivery

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 53 NATIONAL VIEW ON AN AGING POPULATION What Should We Do?  Make representation to Governments to continue to change the system Provincial Governments Federal Government Joint Federal/Provincial

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 54 NATIONAL VIEW ON AN AGING POPULATION 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

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 55 NATIONAL VIEW ON AN AGING POPULATION 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

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 56 NATIONAL VIEW ON AN AGING POPULATION Final Thoughts

28 November rd Annual Canadian Employee Benefits Conference Ambrose M. Hearn, CHE CEO, VON Canada 57 NATIONAL VIEW ON AN AGING POPULATION Thank you for your attention. Good Luck