Ways to Improve National Health Systems

Resource scarcity is the underlying principle for why health systems cannot offer all medical services to everyone all the time. As a result, economic and ethical decisions are made concerning how resources are allocated. However, it is important to note that providing healthcare for everyone is a realistic goal.

In Asia there exists a huge gap between countries concerning the quality of care delivered and a healthcare system’s performance. These differences stem from the level of a country’s economic stability, political leadership and other demographic and health indicators.

Because of new tools many advanced countries are now in the position to create high-performance health systems. To bring about this revolution, patients and providers must be empowered to improve the care they receive and offer. The tools are better information, payment reform and improved primary care.

What’s more, the relationship between doctors and patients is evolving, although it still remains at the heart of medicine. In the last few decades, this relationship has changed along two major axes: clinical care and society.

Medical Care

Until the 1960s doctors focused solely on the well-being of the patient without any regard to patients’ rights. However, the past few decades have seen a wide-scale societal shift that has championed patients’ rights. Decision making shifted toward the domain of the patient, and when the Internet came along patients became more than decision makers. Some even began to entirely manage their own medical treatment, using physicians as consultants.

However, the wealth of information available on the Internet proved just as dangerous as helpful. Today, physicians are patients are moving back toward a healthy balance of power involving shared decision-making. In this situation, doctors are considered expert in medical science, whereas patients decide matters having to do with values or preferences.

The Centers for Medicare and Medicaid Services (CMS) is the largest health insurer in the U.S. It focuses on three main goals: better care, better health and lower costs. Major efforts are underway to make care patient-cantered. These goals will become more and more important as CMS tries to link health care providers’ performance to the reimbursements they receive.

In Australia, the National Healthcare Agreement was signed by national and state governments in 2017. This document summarizes the goals of the health system and lays out the responsibilities of the different governments in providing and managing health services. Those who have signed the National Healthcare Agreement are accountable for the progress they have made concerning the agreed upon outcomes. Included in the agreement was a list of output and progress measures to assess these outcomes.

However, these measures have been critiqued as they work well for patients with a single disease, but could be inappropriate for those with multiple conditions, short life expectancy or severe disability. An alternative approach is to focus on each individual’s health goals and then determine whether these goals are being met or not.

Health Care Systems and Society

Even though the United States spends more on healthcare than any other country, it does not attain the same levels of health achieved in other countries with more limited resources. Singapore has significantly better health outcomes than the US despite having a shortage of nurses and spending much less.

Enhancing access to care at all times of the day and night is essential to improve care for patients with complex conditions. In addition, payment reform is fundamental to reduce costs and improve quality. Coordinating care and managing costs depend on having timely, accurate and actionable information so that doctors can make informed decisions. This means that health information technologies are imperative to improving care for high-cost patients.

Article Reviewed by Dr Alastair Brown (FRACGP MBBS BMedSc DCH) on