Lack of investment in health systems as the biggest challenge to make more resilient and sustainable health systems than ever before. For the first time in history, a health crisis has shut down the entire global economy, painfully demonstrating how inseparable healthcare and the economy have become, while most of the countries in the world and their national health systems were not and still are not prepared for this. Such unpreparedness is caused by two reasons.
Firstly, there is no commitment to long-term financing/investment in healthcare. Health is still not a priority in the budgets of Governments’. The lack of investment in health systems, while saving money in the short term, can have devastating effects on the economy and society in the long term. Therefore, it is critical that countries do not assume that rebound in economic growth is the beginning of the end to problems in health financing. It is not. Navigating the next 2 years wisely will be critical to avoiding cuts in health spending that could push many countries even further behind on their journey to self-reliance.
The crisis has also clearly defined the consequences of confusing short-term cost savings. For example, reduction of the workforce and implicit attrition in service delivery have left some countries ill-equipped to deal with the spike in demand for healthcare. Healthcare cannot continue to be managed as a cost; it should be approached as an investment. Stronger and more resilient health systems are not the cost to our economies but an investment in future preparedness.
Secondly, health budgets are still, to a large extent, fragmented in different silos. Financing health systems are still not based on an integrated budget, including both health and social care. National health systems mostly operate on annual budgets where the value and long-term benefits of health investments are not assessed or considered when evaluating health interventions. This crisis is an opportunity to design a new way of financing health systems based on an integrated budget, including both health and social care, which would also provide appropriate incentives to direct investments into services and technologies that bring benefits in the longer term. Such an integrated approach would enable using the designated budget with greater leverage, and make health systems more resilient and more agile in responding to people’s needs and external shocks.
Integrated and long-term financing instruments would also create incentives for innovative practices and interventions that free up resources in other parts of the system but are hard to justify under the annual budget process. If we believe that hospitals should have the capacity to care for patients in need of emergency or intensive care, they would need to be freed from treating complications related to chronic conditions which could be managed better at other levels of the health system, or by the patients themselves in their own homes.
Strengthening of health services is the essence of changes in technology in 2021
In my opinion, further changes/improvements in telehealth technologies (which went from a “nice to have” to a necessity almost overnight (globally 58% of countries are now using telemedicine; in low-income countries this figure is 42%)) should not be considered the most awaited technology changes. They already are a must, and they will come anyway. Technology changes that are really anticipated in 2021 will most likely be aimed at coping with medical care access and delivery disruptions, especially for non-communicable diseases such as diabetes, cardiovascular diseases, cancer. These new technological advancements should enable healthcare systems to be more prepared to “build back better” - strengthening health services so they are better equipped to prevent, diagnose and provide care in the future, in any circumstances.
For example, the adoption of A.I. to aid in a plethora of health-related fields from supporting healthcare logistics, drug discovery, to assisting in medical decisions or analysing the ever-increasing volume of medical information and research data, and even improving working conditions in hospitals. The possible uses of artificial intelligence are nearly limitless, and I’m only scratching the surface with the examples above. What is certain is that with the right use, A.I. will be a platform for every single person in healthcare to take healing, patient care, and disease prevention to the next level.
Another example - at-home lab tests, home sensors, COVID testing devices, and, of course, the multitude of apps of all kinds from work, efficiency, meditation to sports, finance, conspiracy are all the result of this change. Most of these solutions, lifestyle choices, and working methods will stay with us in the future, hopefully slowly bringing the cultural adaptation we so often talk about in healthcare.
Hence, like any crisis, the COVID-19 pandemic brings with it not only damage or uncertainty but also opportunities. The only question is whether and how they will be used to create a more efficient, effective, and equitable healthcare system.
These sources have been used in the preparation of this article: worldbank.org, medicalfuturist.com, McKinsey, efpia.eu, deloitte.com, oecd.org, who.int.
By Rūta Pumputienė, Life Sciences Law expert, attorney-at-law, Founder of Ruta Pumputiene Law Firm