“The decisions in the health care sector are taken by a handful of people who ultimately live from everything staying just the way it is. That is why decisive questions are not asked such as: What are we actually getting for our money?” US economist Uwe E. Reinhardt, a Professor at the Woodrow Wilson School of Public and International Affairs at Princeton University, posed this question today at the opening session of the European Health Forum Gastein (EHFG) and promptly answered it: We could be getting more.
Prof Reinhardt: “It is striking that Germany has many more physicians than Great Britain yet does not really rank that high in health matters. People in Scandinavia are healthier than in Germany yet spend much less on health care.” Prof Reinhardt argued that the rigidity of many systems is the reason for suboptimum results, adding: “For instance, the sharp distinction between intramural and extramural care. We have to be more flexible in the future. Many European countries have extremely rigid institutions. The US has an advantage when it comes to structures for integrated health care in which the distinctions between hospitals, private practices and prevention disappear. India, for its part, is highly innovative in designing and planning the procedures in hospitals. Expertise is what keeps costs low in India, not just cheap labour. We have to learn from each other.”
Prof Reinhardt: “The inertia of the apparatus is a grave problem for health care systems in the industrialised countries. People have become accustomed to there being a lot of money available and are geared to ‘business as usual’ as a modus operandi. Those days are over now.” Prof Reinhardt went on to say that there was a need for imaginative, creative and radical solutions (disruptive innovation) to help redistribute economic privileges in the health care sector and better control the demands for government resources from this sector. “Innovation is often perceived only as a cost driver. Yet it pertains not only to technology with often exorbitant costs. It should also pertain to the financing and management of the health care system. That is the only way things will work out. We need innovation not only with drugs and devices but also in the way we bill medical services, for example”. He noted that a system with service-based payment automatically drove costs upward because it created incentives to do as many examinations and treatments as possible.
“The most important innovation will be to motivate patients to take greater personal responsibility for their own health. Patients have been a very passive factor in health production thus far. Change in this area should also be supported with financial incentives and definitely also financial penalties,” Prof Reinhardt said. But people also needed information on how to achieve a healthy life style: “More money, public money, should therefore also be invested in research on nutrition and exercise.”
„Resilient and Innovative Health Systems for Europe” is the slogan for this year’s EHFG. More than 550 participants from some 45 countries are attending Europe’s most important health policy conference in Bad Hofgastein to exchange views on key issues affecting European health systems.
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