Jussi Huttunen: Money and health

The lack of money forces us to discuss what is essential and important in health care. Are we doing the right things and are we doing them correctly? How much of common resources can we use for health care and where do we find the money for its ever-growing needs?

Money and the economy have a significant effect on the health of the people. The richer the population, the better it can promote and maintain the health of its citizens. But this is not just a one-way effect. Health promotes a nation’s or opportunities to succeed. The healthier the population, the better it can cope in international competition. Therefore, it is not surprising that health – measured as life expectancy – and the gross national product have a strong correlation.

The deregulation of world trade and the opening up of borders affect people’s health. People, work, goods, services and capital can move freely. Tax competition decreases opportunities to provide public health services. Marketing and advertising are on the increase. The markets for harmful products are moving to less regulated areas, particularly the developing countries. Demand for efficiency is changing our production methods as well as the structure of work life. Disparities in quality of life are growing and insecurity about the future is increasing. 

The health-care system faces significant challenges. We are able to deal with the consequences of prolonged life expectancy.  The problem is down to – once again –  the baby boomers. Citizens born between 1945 and 1950 will reach the age when they need welfare and care services between the years 2010 and 2030, and this will double the current need for resources. 

A great deal of money will have to be spent if we want to take advantage of the achievements in medicine in the future. Good care prolongs life and produces health and functional ability but it costs money. As a nation, we should become 5 per cent richer every year if we wish to introduce all the achievements of modern medicine. In reality, on average, the gross national product grows annually by approximately 2.5 per cent, sometimes more and sometimes less. Thus the discrepancy between needs and resources inevitably widens further. 

We may be able to prevent or at least try to postpone the health-care crisis by making health care more effective. The workload of staff cannot be increased because they are already working at full capacity as it is. The correct solution is to increase the technical and targeted efficiency of the health-care system by doing things correctly and by using the limited resources where they produce maximum health benefits.

There is a lot to be improved in service structures, education, development and implementation of best practices and the utilisation of information systems and technology.  It is important to see the wood for the trees – to promote the whole instead of partial optimisation. And without pulling together, without seamless co-operation between different parties, it is impossible to succeed.

Jussi Huttunen
has worked as a University Professor, as the Director General of the National Public Health Institute, as the Director General of the Ministry of Social Affairs and Health and has been employed as the Editor-in-Chief of the Duodecim medical journal since 2003. He also works as a Senior Advisor to Sitra’s Health Care Programme. You can send comments and feedback to the writer via Sitra’s communications by e-mail, toimitus@sitra.fi