Health Care as a driver of growth

1. Health Careas a driver of growth Sonja Teughels advisor Voka, Flanders' Chamber of Commerce and Industry

2. Interest of employers in health care • Health care is of major importance in health and well-being of human capital • Heavy burden on labour by taxes and premiums • Rising health care expenses • Employment and export of medical products/know how => growing markets?

3. Total and public expenses health care as a % of GDP, 2001-2050 Growing difference Private individuals and Enterprises Bron:Federal Planningbureau, Study commission for ageing

4. Income tax plus employees' and employers' social security contributions(as % of labour costs, 2003) 1. Single individual without children at the income level of the average production worker. Source: Taxing Wages, OECD, 2001-2003

5. How to control the budget? => Restrictions • Current organisational features of health policy restrict decisive and effective health policy: • Corporatism consultation between: • Health services • Physicians • Separation of health care budget (fees, medicines, administration, …) • Budget for pharma underestimated • In case of exceeding the budget => accountability (for ex: claw back)

6. How to control the budget? => Restrictions • Fee for service • Strong segmentation of health policy and financing • Within curing process • Between cure, prevention and care • No health objectives! • Policy per diagnosted group • Integrated health policy

7. How to control the budget? => Proposals • From financial administration to health policy • Policy / diagnose => integration of cure, prevention and care • Disease management with measurable criteria and monitoring • From heavy burden on labour to financing health care by whole population • General means and premiums paid by everyone for compulsory statutory health insurance including major risks • Private health insurance for covering minor risks

8. How to control the budget? => Proposals • From several authorities to one authority in health policy • From supply to demand • Demand and disease as subject and guidance for policy • Limited service fee • Cost effectiveness • From national to international focal point • Looking for opportunities of growing markets in health care!

9. Health care : growing markets? • Supply of care • High density • Good performance and quality • High level of accessibility • Expenses / capita are at the moment comparable to other countries • Centres of excellence? • Heart surgery? • Clinical trials • Biotech and (stem cells transplant…) • Foreign patients

10. Health care : growing markets? • Research and Development • Biology, bio and medical sciences, Clinical and experimental medicine, … • Transfer to patents is limited • Important input of top enterprises (AG, JF, …) and growing importance of universities and public research centres (IMEC…) • Innovation in health care

11. The Progress of Disruptive Innovation Performance (complexity of diagnosis and treatment) Performance trajectory of (present) sustaining innovation specialist teaching hospital New performance of disruptive technology physician outpatient clinics nurse in office care Self care in home care Time Bron: Christensen C. M.e.a., HBR, 2000

13. Health care : growing markets? • Case Medicon Valley : Öresund • Networking of pharmaceutical companies, government, hospitals and universities => development of spin-offs in life sciences • Clustering of knowledge and experience • Export of know-how and import of foreign patients • Enlarging Europe => offering skills, know-how and products

14. Health care : growing markets? • Main conditions • Keep budget under control • Health policy and health objectives • General more efficiency by: • Transparency • In supervision of patients' navigation of care by for. Ex. EPR, e-health, on line prescription….. • Looking for disruptive innovations