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Sustainable concepts for a future-proof healthcare system

In an interview with Jutta Mutschler, Editor-in-Chief of Market Access & Health Policy, Susanne Pollak and Roland Nagel, Managing Directors of the Health Forums, talk about the health policy challenges that lie ahead in the coming years.

22/02/2023

The extensive portfolio of health forums has now been expanded since the beginning of the year to include the long-established trade journal „Market Access & Health Policy“. What was the motivation to expand your business areas?

Pollak: Für me, it's relatively clear – the Market Access & Health Policy part is a very good fit for us on the publication side, because we are already analytical in the market today and we deal with a lot of policy issues. The different areas complement each other perfectly.

Nagel: I believe that this will result in synergies and that we can generate exciting new topics with which we can also actively contribute to the future-proof development of the healthcare system.

The topic of digitalisation in the healthcare sector is pressing. In your opinion, what can digitalisation achieve in the individual areas of the healthcare system? What potential do you see?

Nagel: For me as a computer scientist, digitalisation is ultimately nothing more than a term for technical progress. I have been observing and accompanying digital technical progress in the healthcare sector for more than 35 years. My conclusion would be summarised briefly: We are making progress, but this progress is not huge. They are greater the higher the level of organisation. If I look at a health insurance company from the inside, for example, a lot has happened in the area of digitalisation. However, when I look at and analyse this topic from an intersectoral perspective, I can only see very small steps in development over the years.

What are the causes and reasons for this slow progress?
Nagel: The first possible reason is the question: do we want to organise digital health solutions in a market economy or a state economy? If we organise the solution on a state level, then the concepts and budgets for implementation must come together. However, we no longer have a problem of realisation in the system, but rather a problem of implementation. As an example, Roland Berger developed the first report for the ministries on telematics in the healthcare sector in August 1997 - 25 years ago. If we look at where we are after 25 years, we can only conclude that progress has been made in this area: Progress in this area is a snail's pace, especially in Germany. To me, it sometimes seems as if people are saying: We are now planning health motorways, but we don't have the money for asphalt and concrete. That simply doesn't work. The alternative would be to rely on stronger competition, i.e. the better service prevails. Competing products position themselves in a competitive market. A price must be found for the product that ultimately prevails in this market. We are currently seeing just how difficult this is in the area of digital health applications. But regardless of which path is ultimately taken, one thing is clear: if we continue at the current pace, hyperscalers will take over the business.
With regard to your expertise, the exchange with your customers – what topics would you put on the healthcare policy agenda for 2023?

Pollak: Financing is and remains an important topic. The second point is care. I believe that we only ever do something when there is a fire. You can see that in the example of pharmaceuticals. Right now there are supply bottlenecks for fever syrup for children. I believe that supply bottlenecks are also looming in the care sector. It is foreseeable that the baby boomer generation will also be dependent on care services in a few years' time. We need to prepare for this in a completely different way than we do today.

This is another situation that will not come as a surprise in a few years' time, but can already be predicted today with facts and figures.

Pollak: Exactly – it can be planned. You could say now: we will need so and so many people in care in the future and we have to think about how we can get enough people into these professions. Only when there is a fire do we come in with a watering can and try to put it out. However, this is not a long-term approach. A key point is that we need to set up the social systems in a sustainable way, especially when it comes to financing. Overall, however, I am also convinced that our healthcare system is very good, despite all the criticisms. There is a lot of catching up to do in some areas, but the system has proven to be resilient in recent years. I have the feeling that the players in the market definitely recognise that sustainable reforms need to be tackled.
Nagel: As mentioned, there is potential for optimisation in many areas when it comes to the future development of the healthcare system. However, I am not a fan of doomsday scenarios – in this case, although I am a Westphalian, I would stick with the motto of the Rhinelanders: Et hätt noch jot jejange. Translated for all non-Rhinelanders, this means: „Everything has still gone well“. We should not simply criticise the construction sites of the healthcare system, but rather focus on how we can constructively solve the challenges and problems. And what contribution the individual market participants can make. The pressure on the system is very high. Now is an ideal time to forge an alliance among the players in order to jointly shape the healthcare system of the future.
News from "Gesundheitsforen" from 22/02/2023

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