Health Care Systems around the world: a comparative analysis and global trends

Speakers: Enrique Ruelas and Eduardo Lara
Most health care systems around the world face similar challenges although under different demographic and epidemiologic conditions. Increasing costs, financing, accessibility, technology assessment, quality and patient safety, are some of the most visible ones. For years, the approach to analyse these situations has been anchored to the present. However, the speed of change, including globalisation, is creating a pressing need to anticipate the future. Therefore, a new prospective and proactive framework is necessary to aim at this fast-moving target. On the other hand, prospective analysis has normally been based on linear conceptualisations of the world. Our health care systems have evolved through the twentieth century solving many health problems, no doubt, but creating others. We seem to lack the appropriate conceptual and strategic tools to make them a lot more cost-effective and responsive to the needs and expectations of the people. During all this time, one might think that by doing the same things at a system level, and applying the newest scientific medical knowledge and technologies, we should expect different and better outcomes. This has not happened. Cost containment strategies are not working as expected. Quality and patient safety has not improved in proportion to the huge amounts of money poured into the systems. Timely access at a fair cost is still a major problem for all: people and political systems. These situations, among others, seem to indicate that we need a different framework to interpret the same reality in order to find innovative ways to deal with them. Complex systems theory could be this relatively new and fascinating tool to understand health systems from a different perspective. In this presentation we analyse some characteristics of health care systems around the world such as coverage, benefits, financing, access, quality and patient safety, as well as management issues, and the impact of all these aspects on insurance strategies, not only as they are at the present time but trying to foresee how these characteristics could evolve towards the future and influence the shape of these very systems. In addition, we propose that in order to do that we all should learn to see the same phenomena through new conceptual eyes such as the ones provided by complex systems theory. Hopefully, by anticipating the future under new frameworks we all could not only contain costs through increasing efficiency without sacrificing quality, one of the major present concerns, but most importantly, to offer the health benefits that all health care systems, including financial institutions closely related to them, are ethically committed to provide for the well- being of the population of our world.