Unfortunately, currently in healthcare in all regions, healthcare demands outstrip the ability to pay for it. Good health is an economic asset; Good healthcare is a political asset; equity of access is important; health (especially in Europe) is increasingly being seen as a right – in contrast to other parts of the world (including the United States!). Unfortunately, GDP growth trajectory won’t keep pace – the current trajectory is unsustainable.
There are multiple forces at interplay here. Here is a nice diagram to depict those forces – and each has far-reaching consequences.
There are 3 challenges that will result in rapid demand for innovation:
1) Higher disease burden, demand, and expectations
2) Higher expenditures without fiscal constraint, sustainability or universal coverage
3) Productivity
How do we get to well-functioning healthcare system? 3 I’s:
1) Include – Move towards universal health care for all of Europe free of impoverishing payments for healthcare
2) Invest – Invest in health systems and enact cost-effective AND evidence-based public health approaches
3) Innovate – Accelerate uptake, roll out and scale up innovations to meet people’s needs
Enabling Innovation – 3 possible solutions
Specifically, he wants to focus more on obtaining a value for the money put in – and that can be defined as health outcomes that matter to patients divided by the cost of achieving those outcomes. The goal is to maximize our efficiency.
He then highlighted some European and national trends.
- Most countries and continents/regions have had increases in life expectancy – including in Europe and North America
- However, with increasing life expectancy means an aging population with chronic diseases and “multimorbidity”
- Health systems resource use: 80/20 rule
- That 20% includes the elderly and patients with chronic diseases
- Current systems aren’t in place to help effectively take care of these populations
- More money spent does not mean better healthcare! This goes back to “value” based healthcare. A perfect example is an amount the US spends on healthcare – for no different outcomes that many other countries. The US spends more on health care than the GDP of some European countries.
- Europe is a “tale of 2 stories” – eastern and western Europe are very different
- Healthcare expenditure varies greatly across the European Union – looking at the amount of money spent per person, ranges anyway from 800 Euros (Romania) to 6000 Euros (Luxemburg).
Presented by: Vlad Voiculescu, Bucharest, Romania
Written by: Thenappan Chandrasekar, MD, Clinical Instructor, Thomas Jefferson University, twitter: @tchandra_uromd, @TjuUrology at the 2018 European Society for Medical Oncology Congress (#ESMO18), October 19-23, 2018, Munich Germany
Further Related Content: Pillars of an Effective Healthcare System in Europe Key Components of a Well-Functioning Healthcare System