Important Role of Data-Based Solutions, Prevention and Awareness of People in Future Healthcare
In Estonia, there are several areas of concern relating to health that require the improvement of healthcare, at the same time, however, changes in the behaviour of people towards the emergence of a healthier self is even more important.
This study focused on most important trends, which were also discussed in the previous issue of Riigikogu Toimetised. During the expert discussions, two important unspecified impact factors became evident from these trends: first, the health behaviour and epidemiological picture and second, the development of health technology, digital infrastructure and use of it in both prevention and treatment. A health transition may take place in health behaviours – health behaviour becomes better and more similar among the people, or turns even more diversified, so that behaviour patterns on average remain the same as today, while differences in healthy behaviour widen. On the technological side, the alternatives are broad use of technology, where technological innovations are available to most people or all people can indirectly benefit from them, and restricted use of technology, where the technologies exist but there are no solutions that cover all social groups.
Health behaviours and impact factors of technology form four scenarios: “A dream of Healthcare”, “A pragmatic world”, “Half of the work” and “Keep carrying on”. “A dream of Healthcare” combines better health behaviour and broad use of technology in both prevention and treatment, and extends healthcare service, in particular, everybody would be covered by health insurance. In comparison with “A dream of Healthcare”, the technological side in “A pragmatic world” is primarily connected with treatment, the range of healthcare services does not increase, but everybody gets health insurance. Private insurance is established to cover cost sharing. In “Half of the work”, better health behaviour and narrow use of technology meet. If general health insurance cannot be afforded, the family physician service and compensated medicinal products will be accessible to everyone. In the scenario “Keep carrying on”, health behaviour becomes more diversified and the technologies will be for those who are ready to pay for it. The healthcare system will continue as it is.
The opportunities for additional funding were also studied: provisions for under 19-year-olds, raising social tax by 2%, splitting social tax between the employer and the employee, and applying health insurance tax to all other revenues. Each new service or change requires additional funding, and even if nothing is changed in the health care system, the funding of the Health Insurance Fund will still fall into deficit. None of the analysed sources of additional funding would be able to bring the budget of the Health Insurance Fund into balance. Most probably, the solutions lie in the combination of several important factors – possibilities of additional funding, moving towards efficiency in funding of healthcare, healthier behaviour, etc.