Eight interventions to improve health care outcomes and reduce costs

The NL budgetary state is precarious with health spending accounting for 38% of the budget. Aging of the population  will induce further  stress on health spending. Health spending per capita is the highest in Canada and health outcomes the worst, revealing NL as having a poor value health system. Change is necessary and value should be improved by the following 8 interventions : (1) increased social rather than health spending , (2) restructuring of the health system with less dependence on institutional care and more on community care,(3) transformation of primary health care ,(4) integration and enhancement of health care through technology,(5) A Quality of Care Council to reduce  unnecessary interventions and obtain better  care by getting the right intervention to the right person at the right time, ( 6) national Pharmacare ,(7) a cultural change emphasizing support of Medicare and away from demand and entitlement , (8) A 10 year Health Accord NL signed by the major stakeholders .