Challenges in delivery of Healthcare

The world's population is ageing and the elderly enjoys longer life expectancy. Thus, there is an increasing number of elderly people whose needs and demands differ from the younger generations. The longer life expectancy is due to better provisions of healthcare and technological advancements. At the other end of the spectrum, birth rates are declining. Thus, there is a gap and "an unbalanced age" equation. The replacement numbers do not add up!

Governments, the world over, have the inherent social responsibility to ensure that "every of  their citizens, including the poor and destitute, will have access to medical and healthcare services" ie safety net.
Meanwhile, healthcare costs are escalating rapidly. Thus, inevitably the younger demographic, which are the productive age-group, will be expected to play greater role, towards healthcare financing cost. Thus there is a search for funding mechanisms that will need to meet the social, political and economy of the country.

It is also to be noted that, the demands of the healthcare, with ageing population, will also shift from acute to chronic care which encompass therapeutic to welfare services, wellness, rehabilitative and social support. The "care" component of 'healthcare' will thus become more dominant and will be expected to be embedded in the approach to healthcare policy as we move forward.

The public sector, ie the Government, is typically the largest healthcare provider and will be expected to continue the "de facto" role in healthcare provisions. It also formulates policies and is the guardian, driver and enforcer of the healthcare systems . In short, Government is expected to be responsible for effective universal healthcare coverage of its citizens and ensuring that provisions of technology and services are of quality, safe and effective besides being accessible and affordable.

Moving forward, Governments, the world over, are also introducing new measures to reduce healthcare costs. Policies and programmes like "more generic drugs prescribing" by the medical fraternity, accessibility or sharing of "high-end" diagnostic machines in the private sector to Government hospitals' personnel (and vis-à-vis) and "consumer health and wellness  empowerment" through education are just three examples.

The practice of inclusive partnership and collaboration between the Public and Private sectors, including the insurance fraternity and community, in managing and controlling healthcare costs seem to be the best way forward for Governments. Meanwhile, the search for ideal mechanism for effective healthcare financing in each geography continues ...

Percentage (%) of Government vs Private share of Healthcare Funding (2010):

Vietnam:  37.1 vs  62.9
Thailand:  75 vs  25
Singapore:  31.4 vs  68.6
Philippines:  36.1 vs  63.9
Myanmar:  12.1 vs  87.9
Malaysia:  55.5 vs 44.5
Laos:  46.5 vs  53.5
Indonesia:  36.1 vs  63.9
Cambodia:  21.5 vs  78.5
Brunei:  86.5 vs  13.5
Source: WHO Health Statistics 2013

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