How to make the Healthcare System Sustainable (…and enjoyable)
My vision towards the Healthcare System and how we are involved in it to make it sustainable in an enjoyable way
Let´s briefly analyze three different situations.
In the US Market, the average per capita expenditure goes around USD 8K; the highest in the globe, and the outcomes according to the WHO are almost 5 (in a scale of 10). That as a whole represents 18% of the annual GDP and growing.
In the European Union, the average per capita expenditure goes around USD 3K; and the outcomes are on top of 8.
In Malaysia, the average per capita expenditure is UDS 350; and the outcomes very similar to the European Union.
What else?
In the western countries; 95% of the total healthcare expense is used to recuperate and rehabilitate the patients; out of that amount:
- 47% goes to pharma
- 13% goes to the Care Givers (Doctors, nurses, etc.)
- 10% goes to the MRI services
- 9% goes to infrastructure
- 7% goes to laboratory samples
- 14% goes to other type of services and procedures
Why?
The problem is that in a supposed “healthy” system, we should first PROMOTE healthy lifestyles, then PREVENT according to age, gender and level of activity, and finally RECUPERATE & REHABILITATE a person when sick or injured.
It is evident that as in most of the business models to properly work and make sense, the incentives should be aligned; that is really not happening here in my opinion from a stand point on which there are NO incentive to keep a person healthy, otherwise, most of the chronical diseases that are growing double digit every year because of the “modern” lifestyles, full of fast food, no time for physical activity and unlimited work hours that deteriorate your health (stress I believe is called) are still the norm. Just look at all the “best selling” series on Netflix and the so called “cool” lives they show and of course the pretty and immortal people involved on the dramas. All lies…none of them eat, sleep or work as they appear to.
The Proposal
We need to go back to basics, probably to “the little house on the prairie” way of looking at things; frugal, simple, not necessary easy but full of activity, proper dieting and mainly balanced; that was not a long time ago in galaxy far far away, my grandparents lived that way and I have recently celebrated my grandmother’s 101 birthday. She has probably not the perfect diet (sugars and liquor once a week) but gets checked every month and walks still at least 15 to 30 minutes a day.
There is no reason to limit our lives and aim to have more dreams than remembers, because we as normal and common people can PROMOTE how to live better, share time and good food with family and friends, get connected and very close to the care givers as friends and not as people you need to see only when something hurts or goes wrong.
The final stage should be to get payed for not getting sick and live longer (that’s my dream)
I agree with you about promoting healthy lifestyles and the emphasis being on PREVENTION.
Have incentives to motivate people to follow this trend. Get a tax break for leading a healthy lifestyle.
Organizations give out gym memberships as a benefit .
Yoga or Marshal arts along with meditation should be part of the school curriculum. Stress management.
Classes on nutrition, healthy school meals should be introduced to children at home and school from a very young age.
Make it a point to shop at the farmer’s market once a week in addition to our regular grocery store.
Nice discussion. I would like to suggest two other KEY WORDS that might contribute to understanding the existing gap between investment and outcomes in some places and the efficiency in others. EDUCATION and INEQUALITIES. PROMOTION and PREVENTION are actually being implement (although without enough precision) and actually successfully used by SOME but NOT ALL. Depending on education level and socio economic situations the prevention messages make sense or not. Is eating apples and oranges instead of fast food the main daily life problem of all of us? Is having enough sleep hours an obession for all of us? Is having physical activity thrice a week the main weekly goal for all of us? Are we all living the enjoyable lives that prevent us the need to use addictive substances such as alcohol to forget the huge difficulties one can face? The problem is that as long as inequalities keep growing it counterbances prevention efforts and SUCCESS. Coming back to the data, the countries that perform best are the one with the lowest INEQUALITIES and highest EDUCATION levels. What about making a ‘Department of Disease Care’ accountable for improving the care of people with disease and investing in a ‘Department of Education and Equality’ to make it much more accountable for improving the population health overall not for some of us only.
I like it. Agree with above that the social determinants of health also need to be considered and worked on, in order to really focus on prevention, education, promotion, etc. We also need to understand the impact of stigma and societal pressures on mental health and the impacts that have on the mind and the body. An investment in our socio-economic infrastructure that supports everyone – perhaps not equally, but based on what they need, will pay dividends in reducing health treatment expenditures – shift to keeping people healthy versus just treating illness.