Our health care system is in crisis. Admission to a hospital can spell financial ruin for many middle-income people and for some it is completely out of the question … they simply cannot afford it.
Pharmaceuticals are beyond the reach of many people. Doctors may write prescriptions but the ill cannot always afford to have them filled. Even those with diseases such as hypertension, diabetes and other life-threatening illnesses that need daily treatment cannot afford to buy the medication that they require every day simply to survive.
Does that sound like the country that you live in? Let me tell you that most of those of those circumstances fit just about every country in the world because the health care system of every western country is in crisis.
A recent global survey by the PricewaterhouseCoopers Health Research Institute, that interviewed 700 health leaders in 27 countries, has revealed that health systems around the world are under siege and many will be completely unsustainable with 15 years unless fundamental changes occur. The need to deal with the crisis is recognized by governments around the globe but the urgent solutions that they need are not going to be found within their own country.
Instead health care experts are looking beyond their own borders for shared solutions. Almost every country has some part of their health care system that works very well but overall every system has insurmountable problems.
The survey suggests that governments will need to work together with each other and with private industry and consumers to overcome the problems. And the survey stresses that consumers will also have a bigger financial stake in the new health care systems and a greater responsibility for their healthcare.
Even in systems where historically the tax payer has paid the nation’s health care bill a move towards a greater shared responsibility is beginning to appear and only a small number of the health leaders who were included in the survey think that a tax-funded system is sustainable.
So what will the future look like?
The survey suggests that consumerism will change the way health care is delivered. As individuals assume greater responsibility for their healthcare they begin to demand accountability and information about pricing, safety and quality so that they can make better decisions about what they are “buying”.
The survey suggests that healthcare organizations will have to publish or perish. Like other industries do now private healthcare providers will have to report their prices, error rates and safety standards and eight in every 10 healthcare executives who were included in the survey suggest that transparency will be one of the most important features of a sustainable health system. Sadly two-thirds of those surveyed believe that hospitals are not yet prepared to meet the challenges of consumers who expect to be informed.
At the same time as consumers are becoming more informed about health care they are also becoming more concerned about wellness and prevention. Almost everyone accepts that preventive care and disease management are the most important ways to reduce healthcare costs.
Governments and even employers are beginning to demand health promotion and wellness initiatives that include things like smoke free work places, offices, entertainment areas and public spaces.
Pay-for-performance initiatives are also beginning to be recognized as an important way to keep medical expenses down. Early diagnosis of such diseases as cervical cancer and coronary heart problems are being encouraged so that less radical and less expensive treatment can be used early in the life of the disease rather than later when the costs escalate.
In California doctors are receiving bonuses for screening patients for those conditions and similar programs are coming into place in some European countries too.
Flexible care models are also being investigated. Hospitals are being redesigned; new ways to use technology and outsource elective procedures are also being discussed. An example of that is occurring in German where a medical company is constructing smaller hospitals and connecting them to a highly specialized and centralized high tech medical unit.
In Australia 45 hospitals now offer “Hospital in the Home”, a system where patients remain at home and are visited by traveling nursing staff who take care of their needs.
While the current healthcare system is in crisis throughout the world steps are being taken to overcome the problems but it will mean an incredible shift in the way we, the consumers, think of healthcare and the way in which healthcare providers actually deliver it. Our traditional views will fade away as new innovative and more economic ways of treating the sick and injured come into use.
Consumers can expect to have to contribute more both financially and through self-management of their condition and for many that will be quite achievable. But sadly this report seems to have ignored what may happen to the poor and economically disadvantaged when they fall ill.
Will their situation and level of treatment improve in this coming brave new world of healthcare? That is yet to be seen.
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