Blog – How to address issues with the Healthcare Delivery Model – Canada and the World Healthcare continues to be one of the largest expenses for provinces and territories across Canada - https://nationalpost.com/news/politics/health-care-funding-deadlocked-as-trudeau-says-provinces-wont-get-more-money-without-system-reforms Healthcare needs to move to homecare model as part of managing beds across the healthcare system - https://www.marketwatch.com/press-release/home-care-services-market-size-in-global-survey-2023-with-risk-analysis-by-company-profiles-forecast-timeframe-2026-2022-12-12 Digital healthcare needs to be embrace by all levels of government as part of managing healthcare including improving outcomes - https://www.mckinsey.com/industries/life-sciences/our-insights/german-e-health-offerings-expand-but-adoption-remains-uneven Technology continues to evolve with healthcare. More needs to be done to embrace technology as part of improving patient outcomes. https://www.forbes.com/sites/forbesbusinesscouncil/2022/12/09/future-of-health-top-five-digital-health-innovations-for-2023/?sh=21184fab1e5e or https://www.beckershospitalreview.com/innovation/the-top-innovation-trends-of-2022-according-to-health-system-execs.html Health and wellness programs need to be expanded through tax credits and other policy changes - https://www.shopify.com/ca/enterprise/health-wellness-trends More needs to be done to address seniors living in poverty including adjusting GIS to a new threshold of 40K - https://www.springfinancial.ca/blog/boost-your-income/guaranteed-income-supplement-gis More needs to be done with hiring practices of healthcare professional including expanding the nurses, doctors, and other healthcare spots at colleges and universities - https://www.immigration.ca/canadas-lack-of-residencies-for-foreign-trained-doctors-fuelling-healthcare-labour-shortage/ Pharma and drug companies need to work with all levels of government to curb the high costs of drugs - https://www.slideshare.net/secret/iXrYNeBocHT51 Opening spots for more assisted living needs to forge ahead - https://www.slideshare.net/paulyoungcga/policy-analysis-seniors-assisted-living-and-longterm-carepptx Healthcare needs to look at privatization options as part of managing the delivery healthcare to patients https://www.expatriatehealthcare.com/the-top-10-healthcare-systems-in-the-world-2022/

1. How to address the Delivery
Model for Healthcare around
the Globe
PAUL YOUNG CPA CGA
JANUARY 2, 2023

2. Paul Young - Bio
• CPA, CGA (1996)
• Academia (PF1, FA4, FN2, MU1. and MS2)
• SME – Customer Success Management
• SME – Risk Management
• SME – Close, Consolidate and Reporting
• SME – Public Policy
• SME – Emerging Technology
• SME – Business Process Change
• SME – Financial Solutions
• SME – Macro/Micro Indicators
• SME – Supply Chain Management
• SME – Data, AI, Security, and Platform
• SME – Internal Controls and Auditing
Contact information email: Paul_Young_CGA@hotmail.com
LinkedIn: https://www.linkedin.com/in/paul-young-055632b/
SlideShare - https://www.slideshare.net/paulyoungcga
Twitter: https://twitter.com/paulyoungcpa
YouTube -
https://www.youtube.com/user/youngercga1968/videos

3. Agenda
 Global Healthcare spending
 Efficient Healthcare Countries
 OECD and Healthcare
 USA – Healthcare Waste
 Canada and Healthcare Waste
 Global Healthcare Delivery and Cost

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. Healthcare spending per capita

7. Healthcare spending per capita
Source - https://www.cihi.ca/en/national-health-expenditure-trends-2022-snapshot

8. Healthcare by area
Source - https://www.cihi.ca/en/national-health-expenditure-trends-2022-snapshot

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

10. Most Efficient Healthcare System
Source - https://fr.april-international.com/en/healthcare-expatriates/which-countries-have-
best-healthcare-systems

11. OECD and
Healthcare
Funding
SOURCE – FRASER INSTITUTE

12. 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=CFODailyAlert&utm_nooverri
de=1&utm_source=CFO-
email&utm_medium=email&utm_content=CFODailyAl
ert_Tuesday_2019-10-22&utm_term=health-benefits

13. 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?

14. 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

15. Blog – Reforming Healthcare
https://twitter.com/waterloosuze/status/15381
36454366478337
@KatharineSmart
The focus on healthcare should be homecare
just like the Drummond Report stated years
ago.
Waste in healthcare needs to be eliminated
like LHINs
Better drug deals to reduce cost of drugs
More digital adoption by healthcare
https://www.slideshare.net/paulyoungcga/hea
lthcare-crisis-canada-august-2019

16. Blog – Healthcare
NDP/LPC (use the PBO Report)
PBO - http://cupe.ca/canadas-health-care-system-about-lose-36-billion. Yet nothing is said on the waste with healthcare, why? http://www.nugget.ca/2015/03/31/workers-rally-for-new-health-accord. It
seems like unions are complaining at funding from the Feds, but say nothing on the LHINs or CCAC - http://blogs.windsorstar.com/opinion/the-stars-view-time-to-audit-ccacs-and-the-lhins or revenue like
Ontario Health Premium that does not go to healthcare - http://www.fin.gov.on.ca/en/budget/paccts/2014/14_cfs.html#operations
BTW: Who are the council for Canadians - Radical groups (friends of McGuinty) – Council for Canadians - http://canadians.org/healthcare http://www.therebel.media/engage_canada_lies?
Pharma Options (Pricing/Provincial deals)
1. http://www.cbc.ca/news/health/pharmacare-is-not-unaffordable-drug-policy-experts-find-1.2994857
2. Provinces Agreement - http://healthydebate.ca/2014/10/topic/cost-of-care/pan-canadian-pharmaceutical-alliance
3. Video - https://www.youtube.com/watch?v=hS4_VLc59kM
Mismanagement
1. What Province has NDP Government? Oops, that is MB. How does MB healthcare system rank? http://www.conferenceboard.ca/hcp/provincial/health.aspx or
http://www.cbc.ca/news/canada/manitoba/manitoba-gets-poor-grade-in-canadian-health-report-1.2954500.
2. Ontario Introduced eHealth, LHIN, etc. as part of managing healthcare. Look what has happen to precious healthcare dollars:
a. - http://www.procurementoffice.ca/2015/02/12/post-ehealth-audit-uncovered-more-health-sector-spending-abuses/
b. http://www.cbc.ca/news/canada/toronto/ehealth-scandal-a-1b-waste-auditor-1.808640
c. http://www.thestar.com/opinion/commentary/2014/02/26/kathleen_wynne_must_clean_up_homecare_mess_hepburn.html"
Many provinces are quick to look for handout without truly looking at the delivery of healthcare dollars. Here is quote from a doctor -

17. Drug and Dental Care
You do realize how expensive these programs are right? You do realize that many Cdns have private insurance,
right? The focus should be the consolidation of different programs.
Pharmacare - https://www.slideshare.net/paulyoungcga/canada-and-drug-costs-pharmacare-how-to-reform-drug-
policy
Dental https://www.smilecaredental.ca/blog/ohip-dental-coverage-free-dental-care-ontario-2021
Fiscal - https://www.slideshare.net/paulyoungcga/fiscal-management-public-sector-canada

18. Homecare
 The homecare model has
been around for years.
DME/HME and other are.
 More need to be done
to move healthcare to a
homecare model -

19. Digital and Automation Adoption
• Healthcare needs to embrace technology as part of modernizing its delivery model
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%5
D=omeda%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

20. Assisted living / Retirement
Blog – Geopolitical Risks and Events – Canada and the World – September 4, 2022
Viruses will continue to evolve. More needs to be done to mitigate the virus threats through better oversight of WHO.
Healthcare sector needs to revisit is model including more private clinics and homecare options.
Addressing shortage of healthcare workers will require more seats at medical/healthcare programs along with how best to
certified health professionals.
Long-term care needs to continue invest in adding bed capacity including more affordable retirement communities.
https://www.slideshare.net/paulyoungcga/geopolitics-risk-and-threats-variants-and-disease-management-
september-4-2022pptx

21. Summary
 Too many governments are throwing money
at they symptoms which never fixed the
root cause when it comes to poor delivery
of healthcare
 The rise of drug costs is becoming an issue.
Government need to look at all aspects of
drugs including procurement, approval,
private insurance vs public funding, etc.
National Pharmacare should never be based
on the proper business cases
 All governments around the world need to
put more focus on front-line services and
less emphasis on administration
 Governments are not getting value for
money for healthcare.
 Waste, fraud and other miss management
need to be reduced.
Blog – How to address issues with the Healthcare Delivery Model – Canada and the World
Healthcare continues to be one of the largest expenses for provinces and territories across Canada -
https://nationalpost.com/news/politics/health-care-funding-deadlocked-as-trudeau-says-provinces-
wont-get-more-money-without-system-reforms
Healthcare needs to move to homecare model as part of managing beds across the healthcare system -
https://www.marketwatch.com/press-release/home-care-services-market-size-in-global-survey-2023-
with-risk-analysis-by-company-profiles-forecast-timeframe-2026-2022-12-12
Digital healthcare needs to be embrace by all levels of government as part of managing healthcare
including improving outcomes - https://www.mckinsey.com/industries/life-sciences/our-
insights/german-e-health-offerings-expand-but-adoption-remains-uneven
Technology continues to evolve with healthcare. More needs to be done to embrace technology as part
of improving patient outcomes.
https://www.forbes.com/sites/forbesbusinesscouncil/2022/12/09/future-of-health-top-five-digital-
health-innovations-for-2023/?sh=21184fab1e5e or
https://www.beckershospitalreview.com/innovation/the-top-innovation-trends-of-2022-according-to-
health-system-execs.html
Health and wellness programs need to be expanded through tax credits and other policy changes -
https://www.shopify.com/ca/enterprise/health-wellness-trends
More needs to be done to address seniors living in poverty including adjusting GIS to a new threshold of
40K - https://www.springfinancial.ca/blog/boost-your-income/guaranteed-income-supplement-gis
More needs to be done with hiring practices of healthcare professional including expanding the nurses,
doctors, and other healthcare spots at colleges and universities - https://www.immigration.ca/canadas-
lack-of-residencies-for-foreign-trained-doctors-fuelling-healthcare-labour-shortage/
Pharma and drug companies need to work with all levels of government to curb the high costs of drugs -
https://www.slideshare.net/secret/iXrYNeBocHT51
Opening spots for more assisted living needs to forge ahead -
https://www.slideshare.net/paulyoungcga/policy-analysis-seniors-assisted-living-and-longterm-carepptx
Healthcare needs to look at privatization options as part of managing the delivery healthcare to patients
https://www.expatriatehealthcare.com/the-top-10-healthcare-systems-in-the-world-2022/ -
The Top 10
Healthcare Systems in the World 2022 Expatriate Group.pdf
National health
expenditure trends, 2022 — Snapshot CIHI.pdf
Home Health
Spending Flat As Health Care Utilization Rebounds - Home Health Care News.pdf
Health-care funding
deadlocked as Trudeau says provinces won't get more money without reforms National Post.pdf
Home Care Services
Market Size in Global Survey 2023 with RISK Analysis by Company Profiles & Forecast Timeframe 2026 - MarketWatch.pdf
German e-health
offerings expand, but adoption remains uneven McKinsey.pdf
Future Of Health Top
Five Digital Health Innovations For 2023.pdf
The top innovation
trends of 2022, according to health system execs.pdf
Top 8 Health and
Wellness Trends in 2023.pdf