In France, as in countless other countries, the healthcare system is faltering. Hospitals are overwhelmed, staff harassed, and patients worried. On a global scale, widening health inequalities continue to increase between those who have access to the best treatment and doctors and those who do not.
On this matter, there are a thousand more or less relevant reasons: increasingly constrained budgets; increasingly expensive equipment and medicine; staff with reduced official working hours but who are in reality exhausted; increasingly impatient patients; refusal by taxpayers and insured persons to pay higher premiums and “social charges” (an ideological term that refers to what are, in fact, also insurance premiums).
If we continue on this path, the healthcare systems of the largest countries will explode. People will be treated more and¬¬ more poorly; we will increasingly die of diseases from which we could have been cured; we will have more and more difficulty recruiting new doctors and nurses, especially in the most demanding specialties, and in those that require the greatest availability.
We will see, and we can already see, the establishment of an “Uber heathcare,” whereby staff will be anonymized and proletarianized for greater profits for the companies that will employ these personnel, insurers that will fund these schemes, and data managers who will not be too far away.
Life expectancy, and especially the expectancy of a healthy life, will decrease, which has already begun in some social groups in the United States.
Nothing is more important to voters than their health and that of their families. As a result, no democratic regime will be able to withstand the unravelling of its healthcare system and in particular the breach of the century-old promise to make the fast-paced advances in medicine available to all.
The reforms to be implemented are immense; and they are not the same for all countries. There are, however, seven common principles that must be respected:
1. Recognize that it is not the supply of healthcare that creates the demand, but rather the legitimate refusal to suffer; and the equally legitimate demand for a good life, for as long as possible.
2. Accept that health (which is essentially, similar to education, composed of services, whose productivity is, by nature, lower than that of other industries) represents an ever-increasing share of GDP.
3. Learn from pricing systems related to medical procedures and staff remuneration.
4. Develop local medical equipment and telemedicine in a coherent manner.
5. Set up specific logistics for patient mobility, to enable them to easily go where the necessary equipment is located. Without having to use emergency personnel, who have other things to do.
6. Put massive emphasis on prevention. In fact, the countries that spend the most on prevention already have better life expectancy than others. Without going so far as to pay doctors only when their patients are not sick, a policy tool used in Chinese healthcare policy in the past, we must spend much more on risk prevention, clean cities and teaching healthy individual best practices: playing sports, eating less and only during meals, eating more slowly, eliminating sugar, processed products, tobacco, strong alcohol, anxiolytics and other drugs.
7. In particular, spend more on your diet than on new video games and other digital devices.
These initiatives will not happen in a day. It implies a huge revolution of the minds and organizing. It is all the more urgent to start now.
j@attali.com