Properly financed and managed healthcare


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Dr Arne Björnberg spoke at the "Health Rationing Conference" in Rotterdam on Dec. 9. He stressed the need to "stimulate healthcare to become a service industry".

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Properly financed and managed healthcare

  1. 1. Properly Financed and Managed Healthcare –the biggest European Engine for Economic Growth? Rotterdam, December 2010 Dr. Arne Björnberg Health Consumer Powerhouse Brussels/Stockholm 1
  2. 2. Prologue: Prologue:Things we must believe in before we carry on! If a human activity is a cost item, or an industry contributing to economic growth, has nothing to to do with the nature of the activity! » This is dependent only on the number of Independent Consumption Decision Makers (”ICDM’s”) Healthcare could and should become an industry, massively contributing to European economic growth! This can be done without sacrificing European values of equity in healthcare! 2
  3. 3. Should healthcare become a service industry?Why not – healthcare is an excellentconsumption item;» not fattening» not immoral» only mildly addictive» very labour-intensive (lots of jobs per M€!)» has a low environmental footprint» cannot be outsourced to India! 3
  4. 4. "Healthcare– the largest industry on Earth” Europe except FSU: Turnover: TUSD 1.4 14 000 hospitals 3.4 million hospital beds 1.7 million doctors 3.9 million nurses ~ 9% of GDP
  5. 5. Healthcare capability and output has been and is growing rapidly (# 1)This is a problem:» medical development is the major reason for the perceived financing problems of healthcare systems – and the need for rationing 5
  6. 6. Medicine – a victim of its own success Change in probability of patient survival if doctor arrives+ C:a Today 1830- 6
  7. 7. Healthcare capability and output has been and is growing rapidly (# 2)This is also a fantastic opportunity:» introducing attractive ways of consuming "extra" healthcare can be done without taking away such healthcare, which people are accustomed to getting through public systems» it also emphasizes the need for doctors and healthcare systems to undertake sorting apart "need" from mere "demand" – this sorting has been practised for decades 7
  8. 8. Not a question of “peddling more appendix operations”! Healthcare has long been in transition from curing sickness to providing wellnessAcute stroke and Rehabilitation Varicose veins Not paid for by public infarct Cataracts Oestrogen treatment Imigran benefit systemsCurative cancer Breast reductions therapy Gonorrhea and clamydia Hip and knee joint Moderate problems”Heavy” psychiatry Palliative radiation replacement from columns 2 & 3! therapy IncontinenceSevere infectional Small varicose veins Cancer surgery Prostate trouble disease Gyms Blood diseases Moderate arthritic pain Cough dropsFractures The bulk of dermatology Severe hip and knee joint WrinklesSevere traumas problems Hypospadi Esthetic plastic surgeryAcute allergic reactions Severe RA Common cold Herbal medicineComplicated Carpal tunnel syndrome Ottitic children Vitamins Gall bladder surgery childbirths 50% of coronary Alternative medicine GastritisChild leukemias bypass operations Liposuction Old patients with less Gall bladder surgery Benign skin spotsMajor bleeding ulcer severe diagnoses Semi-serious ulcers RegaineAIDS Hearing aids Bulk of dental careOld patients with Old patients with PC-based reading aids moderate Antabus severe multidiagnoses Viagra multidiagnoses Mammography Severe dental injuries"Need" "Demand" The healthcare 8 "market"!
  9. 9. Stop the rationing/containmentparadigm!Stimulate Healthcare to grow into aservice industry! 9
  10. 10. Stimulate healthcare to become a service industry! industry! Healthcare is transcending from curing sickness to providing wellness! Keep the present basic coverage provided by public systems (i.e. do not copy American social insurance systems!) Make it as streamlined and pleasant to consume healthcare services as it is to consume package holidays or Korean-made electronics; Yes! Stimulate over-consumption of healthcare services! 10
  11. 11. … and Yes, this is meddling with the issue of EquityIn our present systems, equity problemsfrequently hit the weakest groups ofpatients, not the wealthy and/or well-educatedImproving the opportunities to consumehealthcare services can provide betterhealthcare for everybody! 11
  12. 12. The Key IssuesFinancing solutions » make consumption of healthcare services as easy and convenient as the consumption of capital goods or package holidaysPrioritization within healthcare » open and transparent systems for sorting patients to the separate sides of the "brick wall" 12
  13. 13. Is there a willingness to pay, which is not catered for?Definitely - with the appropriate marketing:”Fly more on Lufthansa - we need the money; » our planes are old » pilots and cabin staff are burned out » management is abysmal » regularity is appalling » check-in queues are mile-long » weather forecast is terrible!”*) *) typical healthcare “marketing” translated to the airline industry 13
  14. 14. How large can the healthcare industry be allowed to grow?Answer: Literally no limit at all, as long asgrowth is fueled by a demand situation, whereconsumption decisions are made by 500 MEuropeans.There is a limit ONLY when healthcareconsumption is “force financed” in such a waythat it automatically makes all other goods andservices more expensive! (e.g. through taxes) 14
  15. 15. EU countries have blocked the underlying growth potential of the healthcare industry by shutting it into the “cost problem strait jacket”! 100 Manufacturing 80 Manufacturing & agriculture & agricultureShare of GNP 60 Private Private services services 40 Healthcare Healthcare 20 Other public Other public services services 0 Unemployed Unemployed -20 EU USA Source: Eurostat 15
  16. 16. So What?Instead of walking around showing perverse prideover the fact that we have been able to keephealthcare below 10 % of GNP -what if in 2025, with justifiable pride, we couldlook back att how we brought healthcare to 15 %of GNP, creating >10 M European jobs in theprocess?And at the same time strengthening Europeanvalues of good access to healthcare for all! 16
  17. 17. The Lisbon Agenda andsustainable financing of healthcare in the EULadies and gentlemen; » "I give you EUR 600 billion of additional economic growth for the EU provided by the largest service industry on Earth: Healthcare!" » and at the same time: improved healthcare services for all! » and Sustainable Financing for Healthcare Systems! 17
  18. 18. So where could all that money come from?The NL 2006 reform provided one essential key: Multipleinsurers, who cannot say No to a patient, secure access to goodhealthcare for all.This provides a clue to the introduction of politically acceptableways to allow additional consumption of healthcare services (i.e.multiple purchasers).Attractive financing solutions for healthcare services can becomeas common as for other expensive consumption items!Reflect: mobile telephones and communication technology has”taken” ~5 % of household budgets in 15 years – where did allthat money ”come from”?
  19. 19. THANK YOU!