Celebrating World Health Day | Deloitte US has been saved
By Karen Taylor, director Deloitte UK Centre for Health Solutions
Most countries face substantial challenges in maintaining high-quality health care, including growing demands, rigid financing models, a scarcity of skilled health care workers, and rising health inequalities that have been exacerbated by climate change. Despite the World Health Organization (WHO) declaring health as a human right more than 75 years ago, health care funding, access, and outcomes vary widely.[i] Deloitte’s vision for the Future of Health (FoH) paints a picture of a new paradigm where digital transformation, artificial intelligence (AI), emergent technologies, and an increase in disruptive health care providers enables a shift from the current reactive treatment model to a more cost-effective and sustainable, proactive health and well-being model.
World Health Day is celebrated each year in April. This year’s theme is My health, my right.[iii]
Leaving no one behind is a central promise of the United Nation’s 2030 Agenda for Sustainable Development Goal (SDG) Target 3.8, which recognizes health as a fundamental human right. Yet, the threat to people’s right to quality health services is increasing for millions of people.[v] The WHO Council on the Economics of Health for All found that while the constitutions of at least 140 countries recognize health as a human right, many have not enshrined this right into law.[vi] The WHO has identified the barriers to this as political inaction, a lack of accountability, and funding, which is often compounded by intolerance, discrimination, and stigma. While inaction and injustice are major drivers of the global failure to deliver on the right to health, current crises are leading to especially egregious violations of this right.[vii]
Data from 2021 shows that at least 4.5 billion people—more than half of the world’s population—were not fully covered by essential health services, leaving them vulnerable to diseases and disasters.[viii]
Why a refresh of the human right to heath is needed now
As highlighted in our November 2023 report on The Future of Health in Europe, individual countries are responsible for managing their own health care. This has resulted in a tapestry of distinct systems, moulded by each country’s specific cultural, economic, and political environments. Health care financing generally comes primarily from three sources (government schemes, social health insurance (SHI), and private health insurance (PHI)). In some countries, particularly in Eastern Europe and many developing countries, there can be significant out-of-pocket funding.[x]
Health spending levels are primarily dictated by political decisions and generally correlate with each country’s economic size or gross domestic product (GDP). Even in countries that purport to provide universal health coverage (UHC), the level of spend per capita, the range of services offered, and extent of cost-sharing varies substantially. For example, according to the WHO, the average annual health care expenditure (CHE) per capita in Europe varies widely between high-spending countries like Switzerland (US $10,897) and Norway (US $9,020) compared to Italy $3,350 and Spain $3,234 or Eastern European countries like Albania $465, Belarus $468, and Slovakia $1,685. Meanwhile the per capita spend in the US is $12,012, Australia $7,055, the United Arab Emirates $2,352, China $671, and India $74. In several African countries CHE is well below $50 per capita.[xi]
Differences in UHC and investment in primary care services have resulted in widely different health outcomes worldwide, including mortality, healthy life-years, and prevalence of non-communicable diseases. Now is a pivotal moment for countries—individually and in collaboration—to reimagine their health care business and operating models and adopt a more resilient, inclusive, and innovative model that accentuates the well-being of its citizens, including a stronger focus on primary care.
Can the Future of Health deliver a much-needed shift?
The Future of Health envisions a shift to prevention and earlier diagnosis, and a focus on early primary care engagement, to help sustain health and well-being and improve the cost-effectiveness of health care and economic productivity. Health and wellness will be organized around the individual, be population-based, efficient and cost-effective. Services will embrace the principles of the quintuple aim (i.e., improved patient experience, better outcomes, lower costs, better clinician well-being, and health equity). It will also promote holistic well-being by delaying and reducing the impact of long-term chronic conditions, providing new treatments and even cures for rare diseases as diagnosis and treatment decisions evolve to align with 5P medicine (predictive, preventative, participatory, personalized and precise).[xiii]
To achieve this future, public health will be a government priority supported by fortified health care infrastructures and collaboration between neighbouring countries to deliver robust infectious disease-combatting strategies. Primary providers will, in partnership with both public and private, primary and acute health providers, deploy AI and digital tech, behavioral science, genomics, and population data to tackle health inequalities and promote healthy living (including intelligent national screening and vaccination programs).
Data sharing between providers will be part of a value exchange within a secure, trusted framework using advanced digital technologies to overcome barriers like cost and geography. This will enable equitable access as services transition from sick care to consumer-led health and well-being. These developments will also help improve trust in health institutions and meet public expectations of care being seamless, safe, and secure.[xiv]
Conclusion
History indicates that transitions are challenging, time-consuming, and require a change management approach. New business, funding, and regulatory models will be an imperative to enable the transition from ‘treatment plans’ to emphasizing prevention and well-being. There will be a need for crucial investments in primary care and public health-led integrated systems, a health care workforce proficient in AI, digital and genomics skills, and the advancement of digitally mature, interoperable data systems. New revenue streams with customized offerings will incentivize healthy behavior among citizens.
With the advent of advanced personalized treatments, governments and other payers will encourage health care disruptors but will also seek evidence on return on investment, as to how treatments can reduce health inequalities and improve environmental and social sustainability. Embracing the FoH drivers could help ensure that all citizens around the world have access to quality health care by 2040. By then, countries will be held accountable by their citizens for providing equitable access and financial protection propelled by strengthened commitments to the SDGs.
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[i]Healthcare in Europe | Deloitte Insights
[iii]World Health Day 2024 (who.int)
[v]World Health Day 2024 (who.int)
[vi].World Health Day 2024 (who.int)
[vii]WHO calls for action to uphold right to health amidst inaction, injustice and crises
[viii]Tracking universal health coverage: 2023 global monitoring report. Executive summary (who.int)
[x]Healthcare in Europe | Deloitte Insights
[xi]GHO | By category | Current health expenditure (CHE) per capita in US$ - Data by country (who.int)
[xiii]Healthcare in Europe | Deloitte Insights
[xiv]Ibid
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