The need for multi-level healthcare governance


The need for multi-level healthcare governance

Together with education and security, health is a major issue for citizens today. Knowing that you are in good health, but also that you will be treated rapidly and receive a high standard of care has been a major concern for Western countries and their citizens for more than 20 years.

Executive summary

To demonstrate that this concern has genuinely been taken on board by governments, we only have to look at spending in OECD countries between 1990 and 2010: over this period, health spending per capita increased by more than 70% in real terms.

However, it took a long time for the governance of healthcare systems to be examined in terms of efficiency (the cost-benefit ratio). The ultimate aim was to improve the health of the population, and this can be seen in the increase in life expectancy and fall in mortality rates for certain diseases, such as cancer.

Nonetheless, some years ago now, primarily in the wake of the economic crisis, governments began slashing their healthcare budgets. For example, within the OECD, while health spending increased by more than 4% per year on average between 2000 and 2009, the equivalent figure for 2009-2011 was just 0.2%. The crisis has had a major impact on this area of spending, which in 2011 represented almost 9.3% of GDP on average in OECD countries.

Inside magazine issue 4 – March 2014

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