In the context of the crisis of Western economies, healthcare, a fundamental part of the welfare state, is coming under scrutiny. The healthcare system has become a key question for developed countries, especially now, when they face deep economic, budgetary and social changes. Is the current system sustainable? In 30 years time will the national healthcare system be like the one we’ve known up to now?
The Continuous Education Program session “What can we learn from international experience?” took this as its theme at the meeting organized by the Alumni Association and addressed by IESE Prof. Núria Mas on April 25 on the Madrid campus.
“How are we going to be able to offer quality healthcare to a growing population at a cost that we can’t afford now?” she asked. In her view, patching up the system and partial solutions were of no use when what we face is a “structural challenge” under enormous “financial pressures.”
“As GDP per capita rises in a country, its inhabitants want to spend more on healthcare,” the professor said. This can be extrapolated to all the countries in the world, including emerging countries, which are leading world economic growth. But what is happening in Western countries, including Spain? Available resources will have to compete with pensions, and to this we have to take into account an aging population which is living longer all the time.
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In spite of the difficulties, the professor is in no doubt. “Healthcare is a great asset in Spain. It’s a sector in which we excel and which we could export.” However, she believes the only possible solution is to “rethink the healthcare system.” “We have to have this debate and accept that we have to talk about it,” she insists.
She doesn’t believe that spending cuts, copayment and revising the services offered by the public system can resolve this structural challenge. “The first thing we must do is look for ways to improve and from there understand what functions and why. It’s not a question of cuts. It’s fundamental to understand the process and we need to begin as soon as possible,” she said.
Her conclusion is clear: the only way to move forward and to improve is to have as much information as possible. “We can’t improve if we don’t know why it’s not working,” she pointed out. During the session, she produced a revealing fact. A report from the United States Institute of Medicine showed that 30% of health spending did not result in improved health.
Once areas for improvement have been identified, she said we should start to act “where it is most important,” such as in chronic patient care. This group of patients accounts for 80% of total health spending in the United States and Europe. Other essential factors are transparency and information as well as involving patients in prevention and self-management of their illness. “We all have to be involved in this debate: citizens, doctors, pharmaceutical companies and politicians. That is the only way we can find sustainable solutions for the system,” she said.