The document discusses various ways to reform healthcare systems globally. It notes that healthcare spending is a large government expenditure and that there are issues with current delivery models. It provides examples of efficient healthcare countries and discusses opportunities to reduce waste and improve value through automation, supply chain reforms, preventative care, and increased use of analytics. Reforming healthcare will require changes to policies, costs, procurement processes, and placing more emphasis on outcomes.

1. Reforming
Healthcare
PAUL YOUNG CPA CGA
OCTOBER 10, 2020

2. Paul Young - Bio
• CPA, CGA
• Financial Solutions
• SME – Risk Management
• SME – Close, Consolidate and Reporting
• SME – Public Policy
• SME – Financial Solutions
• SME – Supply Chain Management
• SME – Business Strategy and Restructuring
Contact information:
Paul_Young_CGA@Hotmail.com

3. Agenda
 Global Healthcare spending
 Efficient Healthcare Countries
 OECD and Healthcare
 USA – Healthcare Waste
 USA Statement Spending / Medicare
 Canada and Healthcare Waste
 Automation / Healthcare
 Manufacturing / Healthcare
 Pharmacare
 Robotics / Server
 Supply Chain
 Performance Audits
 Forecasting / Solution
 Watson Healthcare
 Preventive Healthcare
 COVID19
 Analytics and Healthcare

4. Introduction
 Healthcare is key area for government as it is
large government expenditures
 Too many people do not grasp there are issues
with healthcare delivery

5. Global
Healthcare
Spending
SOURCE - DELOITTE

6. Efficient Healthcare Country Ranking
Source - http://worldpopulationreview.com/countries/best-healthcare-in-the-world/

7. OECD and
Healthcare
Funding
SOURCE – FRASER INSTITUTE

8. USA Waste and Healthcare
Source -
https://www.cfo.com/health-
benefits/2019/10/annual-waste-in-
u-s-healthcare-system-nears-1-
trillion/?utm_campaign=CFODailyAl
ert&utm_nooverride=1&utm_source
=CFO-
email&utm_medium=email&utm_co
ntent=CFODailyAlert_Tuesday_2019-
10-22&utm_term=health-benefits

9. United States / Medicare
Source - https://fiscal.treasury.gov/reports-statements/financial-report/current-report.html

10. USA Private Sector and Healthcare costs
Source - https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-
and-Reports/NationalHealthExpendData/NHE-Fact-Sheet

11. Canada and Healthcare
Source - https://www.cihi.ca/en/canadas-drug-spending-growth-outpaces-that-for-hospitals-and-doctors or
https://www.cbc.ca/news/canada/london/ontario-hallway-healthcare-1.4923954 or https://theconversation.com/how-healthy-is-the-
canadian-health-care-system-82674 or https://www.conferenceboard.ca/CASHC/research/2012/inconvenient_truths.aspx
• Canada needs to review its drug programs. Drug
Costs continues to rise - In 2018, $14.4 billion
(42.7%) of prescribed drug spending is expected to
be financed by the public sector, while the
remainder will be financed by private insurance and
individuals paying out of pocket. Drug spending is
just part of the expected $253.5 billion in total
health spending in Canada this year.
• Hospitals (28.3%), drugs (15.7%) and physician
services (15.1%) are expected to continue to
account for the largest shares of health dollars
(close to 60% of total health spending). The
remaining 41% will be spent on other health care
goods and services, including long-term care
facilities and allied health professionals.
• Fraud or about 12B per year
https://www.claimsecure.com/en/whats-new-
blog/2019/march/11/fighting-fraud-waste-and-
abuse-for-a-healthy-business/
• Miss management and waste – Let’s say about 5% to
10% is waste (est.) then the value could be $11B to
25B per year. Could you imagine how dollars could
be stretched?

12. Global Delivery of Healthcare
Source - https://globalnews.ca/news/3599458/canadas-health-care-system-lower-performing-compared-to-its-peers-study/ or
https://www.theguardian.com/commentisfree/2018/feb/05/americans-uk-health-system-trump-nhs or
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2017
• United Kingdom has many programs that are used to
reign in costs of healthcare, i.e. prescriptions drug
caps - https://theconversation.com/why-the-us-has-
higher-drug-prices-than-other-countries-111256
• Australia has one of the most efficient
healthcare system -
https://theconversation.com/australias-health-
system-is-enviable-but-theres-room-for-
improvement-81332

13. RPA and other Automation- Healthcare
 RPA spending could grow to $5B by 2020 -
https://health.economictimes.indiatimes.com/news/health-it/advancements-for-rpa-in-
healthcare/70358766
 AI and Analytics – 15 applications - https://research.aimultiple.com/healthcare-ai/
 AI revolutionizing healthcare - https://healthcareweekly.com/artificial-intelligence-in-healthcare/
 191 startup companies in AI Healthcare - https://www.medicalstartups.org/top/ai/
 AI and Medicine - https://www.ibm.com/watson-health/learn/artificial-intelligence-medicine

14. Robotics / Healthcare
Source - https://www.industryweek.com/technology-and-iiot/article/21141181/beyond-flattening-the-
curve?utm_source=IY+IW+Daily+Headlines+-
+Morning&utm_medium=email&utm_campaign=CPS200903103&o_eid=7930I4506489J2B&rdx.ident%5Bpull%5D=omeda%7C7930I450648
9J2B&oly_enc_id=7930I4506489J2B
• Medical robots are growing at nearly 15%
per annum -
https://bulletinline.com/2020/08/13/medic
al-robots-market-size-by-top-companies-
regions-types-and-application-end-users-
and-forecast-to-2027/
• Technology and Healthcare -
https://cio.economictimes.indiatimes.com/
news/next-gen-technologies/the-new-
prescription-for-healthcare-robotics-and-
ai/74665547

15. Manufacturing / Healthcare
https://www.industryweek.com/the-economy/public-policy/article/21142527/healthcare-costs-are-killing-us-
manufacturing?utm_source=IY+IW+Daily+Headlines+-
+Morning&utm_medium=email&utm_campaign=CPS200921103&o_eid=7930I4506489J2B&rdx.ident%5Bpull%5D=ome
da%7C7930I4506489J2B&oly_enc_id=7930I4506489J2B
“The cause is simple: the U.S. is the only industrial country where the employer directly pays a substantial share of
employees' health care benefits. In other nations, for the most part, citizens themselves and businesses foot the bill,
through income taxes.”
More work is required to transformed healthcare in USA, Canada, and around the world
https://www.slideshare.net/paulyoungcga/how-does-the-world-reform-healthcare

16. Pharmacare
@DrEricHoskins There is no way Canada is ready for pharmacare as it has many holes, but then again you work in the past for
@ontario_liberal as such you are experience at delivering bad policies!
1. Pharmacare - https://www.slideshare.net/paulyoungcga/can-canada-be-successful-at-pharmacare
2. Government is not working on procurement but pushing prices down - https://www.reuters.com/article/us-canada-
pharmaceuticals/canada-enacts-drug-price-crackdown-in-blow-to-pharmaceutical-industry-idUSKCN1UZ0XH
3. Governments have struggle with drug costs - https://www.ifsd.ca/en/blog/last-page-blog/past-failures
4. There needs to be a global strategy on drug delivery and pricing - https://theconversation.com/why-the-us-has-higher-drug-
prices-than-other-countries-111256
5. United States and Drug Costs - https://www.whitehouse.gov/presidential-actions/executive-order-lowering-drug-prices-
putting-america-first-2/ - More work needs to be done with Pharma as part of management of drug policies -
https://www.bnnbloomberg.ca/pharma-lobby-disputes-trump-s-claim-that-drug-companies-are-negotiating-1.1488060


17. COVID19
 United States –
 Biotech/Pharma trials - https://endpts.com/unheard-of-speeds-trump-warmed-up-to-
biopharma-praises-industrys-coronavirus-response-at-white-house-meeting/
 Trump close the borders - https://www.nbcnews.com/video/trump-defends-closing-
borders-amid-spread-of-coronavirus-79584325772
 Biden said little on the border closing -
https://apnews.com/article/d36d6c4de29f4d04beda3db00cb46104

18. Supply Chain
 More work needs to be done by governments around the world to moved reshoring of
critical products like drugs, medical equipment, and supplies back to their home countries -
https://www.slideshare.net/paulyoungcga/tranformation-of-supply-chains

19. Performance
Audits
 All levels of government along with the private
sector need to look at expanding the role of
internal audit. The role of internal audit can be
streamlined using analytics -
https://www.slideshare.net/paulyoungcga/the-
role-of-operational-and-performancebased-
auditing-on-government-and-the-private-sector
 IBM Internal Audit Solutions -
https://www.ibm.com/ca-
en/marketplace/openpages-internal-audit-
management

20. Forecasting
Solution

21. Healthcare – Smarter Healthcare

22. Preventive Healthcare

23. Analytics and Healthcare

24. Healthcare
 The healthcare system is in crisis due to many factors
 Healthcare systems need to implement better crisis management policies and programs -
https://www.slideshare.net/paulyoungcga/establishing-best-practices-when-it-comes-to-managing-crisis-private-
sector-and-public-sector
 Cost of healthcare need to control through different options including procurement, co-pay, etc.
 Reforming all aspects of Government - https://www.slideshare.net/paulyoungcga/how-to-reform-the-public-sector-in-canada-and-
around-the-world
 United States - https://www.slideshare.net/paulyoungcga/fiscal-and-economic-management-state-and-local-government-united-
states
 Waste within healthcare needs to be curb
 Healthcare needs to emphasis value for money including different ways to improve outcomes of the patient. -
https://www.slideshare.net/paulyoungcga/internal-audit-and-performance-base-auditing