1. 9th PanHellenic Congress on Management,
Economics and Health Policy
Athens, December 5, 2013
Sustainability of our healthcare systems
Elements of a roadmap
Boris Azaïs
Director Public Policy, MSD
2. We live longer and better, but can we afford it?
DEMOGRAPHIC SHOCK
Percentage of people aged 65
and over in total population
Sources: UNDP, OECD
HEALTHCARE COST EXPLOSION
(*) Excluding US - Source: OECD 1960-2005 (pub. 2007)
McKinsey analysis
RISE OF CHRONIC DISEASES
Causes of death:
US, Canada,
Western Europe
Various sources, including CDC, Eurostat, WHO.
COST OF CHRONIC DISEASES
Source: Kaiser Permanente Northern California commercial
membership, DxCG methodology, 2001.
7. Our population will need to be kept healthy
and productive
Dependency ratio in selected OECD countries
Ratio of working age to inactive people
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SOURCE: UN (2008)
8. Our population will need to be kept healthy
and productive
Dependency ratio in selected OECD countries
Ratio of working age to inactive people
“While all OECD countries are experiencing
unprecedented demographic change, which has the
potential to unravel health and social care systems, a
negative outcome is not inevitable.”
Rebecca Taylor, International Longevity Centre,
London
“Health Reform - Meeting the Challenge of Ageing and Multiple
Morbidities”, OECD Publishing (2011)
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SOURCE: UN (2008)
9. Elements of a roadmap
1. Healthcare is the solution, not the problem
2. Focus on the patient
3. Focus on value to improve quality and efficiency
4. Embrace innovation and new business models
5. Promote the Health Economy
6. Adopt Health in All Policies approach
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10. 1. Healthcare is the solution, not the problem
Health spending is a crucial investment to promote economic growth
SOURCE: MSD, adapted from “The contribution of health to the economy in the European Union”,
Suhrcke, McKee for the European Commission, DG Sanco (2005)
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11. 1. Healthcare is the solution, not the problem
Health spending is a crucial investment to promote economic growth
“While health is a value in itself, it is also a
pre-condition to achieve economic growth.”
Council of the EU June 2011
SOURCE: MSD, adapted from “The contribution of health to the economy in the European Union”,
Suhrcke, McKee for the European Commission, DG Sanco (2005)
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20. 6. Adopt Health in All Policies approach
Our health status is shaped beyond our healthcare systems and is not the sole responsibility
of the Ministry of Health
“We have to create an environment conducive
to healthier living. […]
All sectors of government and the private sector
have to be involved; it is not just the
responsibility of the Ministry of Health alone.”
WHO on World Health Day 2013
“All ministers are health ministers”
Sir Michael Marmot, Professor of
Epidemiology and Public Health at
University College London
http://www.euro.who.int/en/about-us/partners/observatory/studies/health-in-all-policies-seizing-opportunities,-implementing-policies
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21. In conclusion: Our policy compass
We believe that policy making in healthcare
should be led by key principles:
- Focus on the patient
- Focus on outcomes
- Reward value across the system
- Promote efficiency and drive out waste
- Be open to innovation
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