Transcript PNW-Healthcare-Overv..

Consultation - Collaboration - Cooperation
Who We Are and What We Do
A Collaborative Approach to Healthcare and Public
Health in the Pacific North West
Wayne Dauphinee
Executive Director
2013
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Pacific NorthWest Border Health Alliance
Canada and US Health Systems: 30K View
CA-US Pan Border Public Health Preparedness
Council
Note: What you see on the following slides is not necessarily what you will hear as they were
prepared primarily for post workshop reference
A non-profit organization, the PNWBHA’s mission is to promote public’s health
preparedness. The Alliance works toward this mission through its activities in
seven essential areas:
• Disease epidemiology and surveillance, including food security
• Emergency management and public health preparedness
• Indigenous health
• Emergency medical services
• Public health laboratories
• Risk communication
• Public health law
The PNWBHA was founded in 2009 and is a member of the Canada-United
States Pan Border Public Health Preparedness Council (PBPHPC)
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PNWBHA promotes public health preparedness by actively
working to:
Advocate the development and implementation of public
preparedness policy;
Facilitate the sharing of health and related information;
Cooperate regionally, nationally and internationally with other
organizations to promote public health preparedness;
Encourage governments to provide sufficient resources for
disease prevention, surveillance and the promotion and protection
of the public’s health
Advance opportunities for professional development.
Alaska
Saskatchewan
Oregon
British Columbia
Washington
Montana
Idaho
Yukon
Core
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Co-Chair (Canadian and United States representatives)
Signatory Representatives
Expanded
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Working Group Leads
Liaison
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Representative from the Public Health Agency of Canada
Representative from United States Department of Health and Human
Services
What is PNWBHA’s future direction?
PNWBHA’s future direction is focused on sustaining and building
current efforts to strengthen public health preparedness. This
includes:
1. Providing a community of practice where public health
preparedness stakeholders from throughout the Pacific
Northwest can come together to engage in dialogue on public
health preparedness issues
2. Coordinating and supporting the extension of existing
arrangements for: information sharing and protection; cross
border movement of healthcare personnel and resources: and
sharing public health laboratory capacity, throughout the region
3. Developing, disseminating and maintaining a map of the public
health and healthcare infrastructure in the Pacific Northwest,
including an emergency response capability index
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Challenge
Differences in epidemiological case definitions, communication
systems and professional licensure are among the issues that must
be resolved in order for provinces/territories and states to enhance
cross-border public health emergency preparedness and response.
Approach
The Canada – United States Pan
Border Public Health
Preparedness Council (PBPHPC)
is comprised of health
department/ministry
representatives from the three
regional border health
collaboratives (Eastern, Great
Lakes and Pacific NorthWest); four
unaligned provinces and states
(Alberta, Manitoba and North
Dakota); and the Canada and
United States federal government
Authority
The PBPHPC draws it authority from the November 2007 trilateral public
health MOU entitled “Declaration among the Department of Health and
Human Services of the United States of America, the Department of Health
of Canada, the Public Health Agency of Canada and the Ministry of Health of
the United Mexican States”.
Mandate
The mandate of the PBPHPC is to facilitate regional pan-border public health
preparedness collaborations to collectively strengthen capacity at all levels to
address all nature of public health threats, including: responding to severe or
novel outbreaks of infectious disease; augmenting disease surveillance in the
face of an evolving or yet-undefined threat; or a need to address non-urgent
public health issues that arise, e.g., transportation of infectious disease
samples across the border.
Goals and Strategic Priorities
PBPHPC activity is chiefly focused on:
• Providing a forum for facilitating pan-border emergency preparedness
collaboration
• Promoting local and regional collaborations in emergency public health
activities.
• Ensuring all pan-border activities are deliberate, realistic and value
added for all members.
• Addressing Federal issues that are common to all Canada – U.S. cross
border health collaborations and require resolution at the Federal level.
• Engaging other pan-border stakeholders when appropriate to assist
regional alliances and activities across the border; and
• Avoiding duplication of established initiatives and alliances across the
Canada – U.S. border
Our Health Systems
A 30,000 Foot Perspective
Health System Overview
CANADA
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A mix of public (70%) and private (30%)
funding
Universal public coverage for hospital and
physician services
Employer based and supplemental gov’t
programs for other health services.
Low admin and legal costs.
Majority of health funding is provincial
with some federal government providing
some funding with conditions.
Slower adopters of new technology.
Per capita spending was USD $1,939
UNITED STATES
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A mixed private/public system.
Largest public (and private) spender in the
world but with identified gaps in coverage.
Employer based coverage for many.
High administrative and legal costs.
Federal government provides funding
through Medicare, Medicaid, SCHIP, and
the VA
Fast adopters of new technology for those
with good coverage.
Pockets of excellence in health
management.
Per capita spending was USD $4,271
Peace, order and good government
Life, liberty and the pursuit of happiness
Public Health in Canada
Public Health
System
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Primary Care
System
Acute Care
System
Public health is part of the overall continuum of health
efforts
Core functions of disease prevention and control, health
protection and health promotion, supported by surveillance, research,
policy and legislation, and human resources
Includes a wide range of activities, from school vaccine
programs, to anti-tobacco advertising, to emergency
preparedness and response
Typical Provincial Health Funding
Income Source
Allocation
Typical Provincial Health System
Service Delivery
Typically Who Pays for What
Payer
What
Canada
Individual
Province
(Insurer)
US
Co-Insurer
Individual
Insurer/
Co-Insurer
State
Medically Necessary
Services1
Public Health
Dental
Optical
Prescription Drugs
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Physical Therapies
Ambulance
1 Physician and diagnostic services and inpatient care, including all
required drug and therapies
2 Income based Pharmacare
How We Are Organized
Washington
How We Are Organized
British Columbia
Typical Regional Health Authority
Consultation – Collaboration - Cooperation
http://www.pnwbha.org
2012