Five days of eight hours each day in a seminar at the TH Chan School of Public Health at Harvard University are enough to put together a general overview of how the American health system works and how it contrasts with those of Latin America. Refocus on primary care, improve the quality of systems, move towards a cultural change to expand prevention, and treat non-communicable diseases in time, There are four key strategies -but not the only ones- when thinking regarding redistributing budgets and reducing costs, especially in less developed countries that suffer from the short sheet syndrome.
“Investing in non-communicable diseases and in health systems is good because it not only has to do with improving the quality of life, if not that also helps to reduce expenses”explained Rifat Atun, director of the Laboratory for Innovation in Health Systems at the Harvard School of Public Health and one of the 12 lecturers. “With better health, people can return to work and that generates a domino effect in favor that impacts the entire economy”added.
For Atun, “in Latin America basic care is outdated and is not highly valued, it is limited and has a negative connotation.” The professor assured that it is essential “make a transition and bring that practice into the 21st century. It must be concentrated on the patient and on the most comprehensive services that work in prevention, diagnosis and home care “. And he warned: “If we improve primary care, we will improve efficiency and equity, and that will give you best value for money invested in health”.
Along the same lines, Margaret Kruk, a professor at the Health System of the oldest university in the United States, agreed that “strengthening the first level of care” is a key piece for that upgrade. According to the expert, there are also two other major items that can contribute to the economy of health. “In Argentina, 74% of the causes of mortality are linked to poor quality medical care and inequality”emerges from the Quality Evidence for Health System Transformation report that the woman prepared and presented to experts from all over Latin America.
During her presentation at the seminar “Health in the XXI Century: Workshop for Latin American Health Care Executives” -organized by the Harvard School of Public Health, in collaboration with LiderLatam and with the support of Roche laboratories-, the president of the Lancet Commission on Global Health assured that “although there is a great push at the global level to improve the quality of services, in low- and middle-income countries there is still a long way to go. According to statistics presented by the woman, 8.6 million people die from poor care per year worldwide.
Emphasis was also placed on the impact of not treating non-communicable diseases in time, such as diabetes, hypertension, and obesity, which kill more than 40 million people a year in the world and Equivalent to 70% of total deaths. In this sense, the conclusion is that not only avoiding death is a key factor, but also detecting them in time and treating them accordingly. can minimize the economic costs that occur throughout the health chain.
According to a study carried out on deaths from treatable diseases in 137 countries in 2018, 540,000 deaths of this type were registered in Latin America and the Caribbean and mortality was due to the low quality of universal coverage systems.
In Argentina, for example, 39,000 deaths from treatable conditions were recorded. More than 74% went to a hospital but they did not receive adequate care. “These data are decreasing, but they are lacking. We have to work on the quality and life expectancy of the population, which is getting higher,” Kruk pointed out.
“Investing in this is good and it is understanding that it helps reduce costs. The fact that a patient enjoys good health generates a positive domino effect that affects the entire economy,” Atun commented. To which Kruk concluded: “Health systems have to offer an economic benefit and a reasonable cost for the country”.
Some local health numbers
The Argentine health system is segmented into three subsystems: public, social security, and private. Total Health Expenditure includes the expenditures of these three subsystems.
In 2017 (latest data available), Total Health Expenditure was $1,005,199 million, which is equivalent in per capita terms to $22,822 per year per person.
According to estimates from four years ago, total health spending represented 9.4% of the Gross Domestic Product (GDP)where 6.6% of GDP corresponds to Public Expenditure on Health and Social Security, and the remaining 2.8% of GDP corresponds to Private Expenditure.
The results by health subsystem show that Public Expenditure on Health is 2.7% of GDP, Social Security Expenditure is 3.9% of GDP, and Private Expenditure is 2.8% of GDP.
Beyond the fact that health is an increasingly relevant issue worldwide, in Argentina it is not among the greatest concerns of its population. According to a survey carried out by the consulting firm Luis Costa & Asociados, interest in public health is in last place, with 3%, behind insecurity (68%), inflation (50%), poverty (44%), corruption (40%) and education (35%).
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