What will the future bring for health and healthcare?

by | 1 February 2018 | Healthcare, Public health

How can the world deliver affordable and high-quality access to healthcare in future, in the face of rising costs, an ageing population and an increase in non-communicable diseases (NCDs)?

Our current healthcare systems are not sustainable. Costs are high, meaning affordability of healthcare is a problem across various systems and countries.

Our current healthcare systems are not sustainable. Costs are high, meaning affordability of healthcare is a problem across various systems and countries. The US is spending by far the most, while Switzerland is the biggest spender in Europe. Other countries, such as Israel, manage to achieve similar or better results for far lower expenditure. This is partly down to the fact that convenient access to family physicians is a cornerstone of Israel’s health service. Data from the Organisation for Economic Co-operation and Development (OECD) show the variation in healthcare spending as a proportion of gross domestic product (GDP) across 35 countries (see figure below).
There are ongoing discussions within European governments about the changes needed in healthcare systems. The media in Germany and the UK, in particular, frequently report on the countries’ methods of delivering care. These two countries – with the Bismarck system in Germany and the Beveridge system in the UK – have helped to shape healthcare systems all over Europe. For example, some eastern European countries have followed Germany’s approach, while countries like Portugal have echoed the UK. What the different systems have in common is that both direct and indirect healthcare costs are huge.

Graph: current expenditure on health as percentage of GDP

Source: OECD

Patients, providers, payers and policymakers often have different opinions about what the healthcare system should look like.

Who are the key stakeholders in reforming healthcare systems?

Patients, providers, payers and policymakers often have different opinions about what the healthcare system should look like. There are various cultural approaches among healthcare systems, and differences between emerging and developed economies. But regardless of the type of system, the common problem is sustainability. Aligning the ideas of key stakeholders and creating common goals will enable services to achieve change and aim for a more sustainable system.

What needs to be done?

Common goals must be formulated by all stakeholders involved. Performance and accountability need to be increased, by introducing shared goals that respond to all stakeholders’ needs. The priority should be achieving high-value healthcare. Current structures tend to ignore measuring value. Providers tend to measure only what they can directly control, rather than what matters for high value or outcomes. A focus on measuring value will reward providers in efficiency, achieving good outcomes and increasing accountability for healthcare.

Efficient health systems have certain structures in common, such as strong primary care and technology to contain costs. A robust primary care system is one reason for the successes of Israel’s healthcare system. Technology to contain costs can help to accelerate activity while increasing the efficiency and accuracy of big data analysis.

There is a need for real-world data and transparency, describing patient outcomes at different stages of disease. Data from clinical trials are necessary, as well as structured and longitudinal data.

It is difficult to say what 2018 might bring. But surely other countries will soon start to follow examples like that of the UK in discussing how to shape the future of health and healthcare.

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The opinions expressed in this blog are those of the individual authors and do not represent the views of The Health Policy Partnership.