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Improving the public debate on Health
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Klaus Gritschneder
„Improving the public debate on Health“
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The German crisis
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• No trust in the work of the politiciansafter one year of conservative-liberal government
• certificate by the press last Sunday
• Frankfurter Allgemeine Sonntagszeitung
chancellor Merkel: 4-minister for education, Schavan: 4minister for transportation, Ramsauer: 4-minister for health, Rösler: 5
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The German crisis
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• Germany has oneof the besthealthcare systemsworldwide
• People`sconfidence in physicians andpharmacists is high
Highstreetpharmacies: 2,4source ABDA
• Mail order pharmacies: 1,7
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The German crisis
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• How can we rebuild the reputation of the health system in total?
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The facts
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• people get elder medical progress increasesthe costs of the system increases too
total costs pharmaceuticals
1995 112474 17938
2000 123914 21776
2005 135877 27610
2008 151465 31586
0
20
40
60
80
100
120
140
160
1995 2000 2005 2008
total costs in bn €
pharmaceuticals
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The facts
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• The same reaction of the politicians in each health reform:additional rebatescost cutting in all sectorsreduction of health care services
• The public debate about health is labeled by controversies between the political parties
• High impact of lobbying groups
• Is that the future?
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5 propositions to improve health care
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1. Demographic change is not the reason for higher costs
2. Health must become cross sectoral
3. We need more participation and self responsibility by thepatients
4. Health care should be a global self learning system
5. Innovation and competition lowers costs
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Thesis 1:
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Demographic change is not the reason for higher costs
It`s true, more people
get older, but …
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Thesis 1:
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Demographic change is not the reason for higher costs
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Thesis 1:
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Demographic change is not the reason for higher costs
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Thesis 2: Health must become a crosssectoral field for action
• Who is responsible for health care?
The ministry of health? – Not only
• Treating deseases is only one part
• Prevention become more and more relevance
• Healthy conditions for everyday life are the fundamental basis to live healthy lives
• All governmental departments are relevant for a better healthcare system
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• Self determination, participation and self responsibility of thecitizens and patients must become the basis for all services
• Politicians protect patients
• The self responsible patient is not existent at the moment
• One example: The discussion about the ownership of medicaldata
Overweight, smoking, alcohol-and drug misuse shows us, thatwe need more education and prevention
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Thesis 3:
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Thesis 4
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5,1
10
14
0
2
4
6
8
10
12
14
Dia
beti
s P
ati
en
ts in
Mio
.
(assu
med
)
2003 2010 2023
source: http://www.zeit.de/2003/48/diabetes_geschichte
To make the health care sector a global self learning
system
One example: Diabetes
Biggest challenge in
Europe for the near
future
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Thesis 4
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Source: whitebook diabetes in Germany
Cost cutting of
drug costs can`t solve
the problem
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Best practice, evidence based medicine
Indications, patients and pharmaceuticals are worldwide the same
Guidelines for the right therapy are different, such as e.g. between Germany and Austria
Thesis 4
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Only innovation and competition lowers costs
One example of Europa Apotheek Venlo:
specialty pharmacy for Multiple Sklerosis:
specialized pharmacists
special CallCenter
goal: better adherence for lower over all costs
less emergency cases
less complications
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Thesis 5
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We need more transparency
We need more information for patients
We need more accountability
It`s a task for all stakeholders in the health system andfor the press to fulfill these demands
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Communication
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Thanks for your attention!
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