The health care bottleneck: burying the future despite more and more money, not daring to make the leap forward

In the debate on health care financing, we have regrettably not talked much about the fact that health care, or healthy people, is an integral part of Estonia’s competitiveness. Even though the economy has stuttered in recent years, we continue to have one of the highest employment rates in the European Union. There is practically no sector in which businesses do not talk about a shortage of workers with the necessary skills. When the economy starts to grow again, this will become an even more pressing issue,” explain Hando Sutter, CEO of the Confederation of Finnish Employers , and Piia Zimmermann, adviser to the health working group, in the opinion columns of Äripäev.

Demographic trends mean that people are fewer and ageing, making it increasingly important to keep them healthy and in the labour market. For example, in 2023, we will have lost more than 424,000 years of healthy life as a society, with health care costs increasing by 12% to nearly €2.2 billion. Our healthcare system is of high quality, the equipment is good and the doctors work with passion. But the measure of health outcomes needs to be re-evaluated. Society is investing the largest amount in health in history, but the number of healthy life years is falling.

The current approach is focused on measuring the process, not the result achieved. Put simply, it makes the patient undergo as many operations and procedures as possible, because this is the most financially beneficial for the institution. While people are being treated well, this metric means that healthcare spending is ballooning like a yeast. However, from the point of view of both the individual and society as a whole, a better measure is the result that the individual gets well as quickly as possible and the number of years lived in good health increases.

We are afraid to look to tomorrow

Better use of technology will also help to meet these objectives. There is a lot of digital health data collected in Estonia, but little use is being made of the potential of this data for service and system development. This is not the case for the use of personalised health data, but for the use of non-personalised big data sets that are sufficient for generalisations and inferences.

For example, data could be used to create new services, international research could be carried out, and the free flow of information between healthcare institutions would reduce unnecessary costs from duplication. In addition, high-quality data can be used to analyse the health problems of the population, for example by occupation or workplace, and to develop an action plan for prevention. This means that people fall ill less often, or less seriously.

The development of digital health data and services is essentially under the control of the Health Insurance Fund, which has an important role as coordinator and needs mapper. However, progress is slow because of limited skills and money, and the cost of the digitalisation backlog is becoming increasingly expensive. Therefore, digital developments in health care should be a top priority for governments.

Health technology as a separate sector

As well as healthier people who need less treatment, there is another reason why it pays to get a leg up on the digital health leap. The health tech sector here is already a strong and distinct industry, and expanding it would bring clear added value to the economy and society. If only we could collectively agree to go down this path.

This week, experts and visionaries from both Estonia and Switzerland, where healthcare economics is a clear priority, gathered in Tallinn’s Kadriorg Art Museum for the Swiss Healthcare Innovation Day conference. The aim is to give decision-makers and policymakers insights, lessons learned and observations from around the world, and the courage to put technology, including the opportunities offered by artificial intelligence, to work for our people and our economy. Healthier people equals a richer society.

As well as tackling today’s pressing health challenges, we need to look to the future to achieve more effective health governance and research and development that delivers value for the state and the economy through better access to health information and data analysis.

The article was published in the opinion columns of Äripäev newspaper.