Dr Arne Björnberg spoke at the "Health Rationing Conference" in Rotterdam on Dec. 9. He stressed the need to "stimulate healthcare to become a service industry".

1. Properly Financed and
Managed Healthcare –
the biggest European Engine
for Economic Growth?
Rotterdam, December 2010
Dr. Arne Björnberg
Health Consumer Powerhouse
Brussels/Stockholm
1

2. Prologue:
Prologue:
Things we must believe in before we carry on!
If a human activity is a cost item, or an industry
contributing to economic growth, has nothing to to
do with the nature of the activity!
» This is dependent only on the number of Independent
Consumption Decision Makers (”ICDM’s”)
Healthcare could and should become an industry,
massively contributing to European economic
growth!
This can be done without sacrificing European
values of equity in healthcare!
2

3. Should healthcare become a service
industry?
Why not – healthcare is an excellent
consumption item;
» not fattening
» not immoral
» only mildly addictive
» very labour-intensive (lots of jobs per M€!)
» has a low environmental footprint
» cannot be outsourced to India!
3

4. "Healthcare
– the largest industry on Earth”
Europe except FSU:
Turnover: TUSD 1.4
14 000 hospitals
3.4 million hospital beds
1.7 million doctors
3.9 million nurses
~ 9% of GDP

5. Healthcare capability and output has
been and is growing rapidly (# 1)
This is a problem:
» medical development is the major reason for the
perceived financing problems of healthcare
systems – and the need for rationing
5

6. Medicine – a victim of its own
success
Change in probability
of patient survival if
doctor arrives
+
C:a Today
1830
- 6

7. Healthcare capability and output has
been and is growing rapidly (# 2)
This is also a fantastic opportunity:
» introducing attractive ways of consuming
"extra" healthcare can be done without taking
away such healthcare, which people are
accustomed to getting through public systems
» it also emphasizes the need for doctors and
healthcare systems to undertake sorting apart
"need" from mere "demand" – this sorting has
been practised for decades
7

8. Not a question of “peddling more
appendix operations”!
Healthcare has long been in transition from curing sickness to providing wellness
Acute stroke and Rehabilitation Varicose veins Not paid for by public
infarct Cataracts Oestrogen treatment
Imigran
benefit systems
Curative cancer Breast reductions
therapy Gonorrhea and clamydia Hip and knee joint Moderate problems
”Heavy” psychiatry Palliative radiation replacement from columns 2 & 3!
therapy Incontinence
Severe infectional Small varicose veins
Cancer surgery Prostate trouble
disease Gyms
Blood diseases Moderate arthritic pain
Cough drops
Fractures The bulk of dermatology
Severe hip and knee joint Wrinkles
Severe traumas problems Hypospadi
Esthetic plastic surgery
Acute allergic reactions Severe RA Common cold
Herbal medicine
Complicated Carpal tunnel syndrome
Ottitic children Vitamins
Gall bladder surgery
childbirths 50% of coronary Alternative medicine
Gastritis
Child leukemias bypass operations Liposuction
Old patients with less
Gall bladder surgery Benign skin spots
Major bleeding ulcer severe diagnoses
Semi-serious ulcers Regaine
AIDS Hearing aids
Bulk of dental care
Old patients with Old patients with PC-based reading aids
moderate Antabus
severe multidiagnoses Viagra
multidiagnoses Mammography
Severe dental injuries
"Need" "Demand"
The healthcare
8
"market"!

9. Stop the rationing/containment
paradigm!
Stimulate Healthcare to grow into a
service industry!
9

10. Stimulate healthcare to become a service
industry!
industry!
Healthcare is transcending from curing sickness to
providing wellness!
Keep the present basic coverage provided by public
systems (i.e. do not copy American social insurance systems!)
Make it as streamlined and pleasant to consume
healthcare services as it is to consume package
holidays or Korean-made electronics;
Yes! Stimulate over-consumption of healthcare
services!
10

11. … and Yes, this is meddling with
the issue of Equity
In our present systems, equity problems
frequently hit the weakest groups of
patients, not the wealthy and/or well-
educated
Improving the opportunities to consume
healthcare services can provide better
healthcare for everybody!
11

12. The Key Issues
Financing solutions
» make consumption of healthcare
services as easy and convenient as the
consumption of capital goods or package
holidays
Prioritization within healthcare
» open and transparent systems for
sorting patients to the separate sides of
the "brick wall"
12

13. Is there a willingness to pay, which
is not catered for?
Definitely - with the appropriate marketing:
”Fly more on Lufthansa - we need the money;
» our planes are old
» pilots and cabin staff are burned out
» management is abysmal
» regularity is appalling
» check-in queues are mile-long
» weather forecast is terrible!”*)
*) typical healthcare “marketing” translated to the airline industry
13

14. How large can the healthcare
industry be allowed to grow?
Answer: Literally no limit at all, as long as
growth is fueled by a demand situation, where
consumption decisions are made by 500 M
Europeans.
There is a limit ONLY when healthcare
consumption is “force financed” in such a way
that it automatically makes all other goods and
services more expensive! (e.g. through taxes)
14

15. EU countries have blocked the underlying growth
potential of the healthcare industry by shutting it into
the “cost problem strait jacket”!
100
Manufacturing
80 Manufacturing & agriculture
& agriculture
Share of GNP
60 Private
Private services
services
40
Healthcare Healthcare
20 Other public
Other public
services
services
0 Unemployed Unemployed
-20
EU USA
Source: Eurostat 15

16. So What?
Instead of walking around showing perverse pride
over the fact that we have been able to keep
healthcare below 10 % of GNP -
what if in 2025, with justifiable pride, we could
look back att how we brought healthcare to 15 %
of GNP, creating >10 M European jobs in the
process?
And at the same time strengthening European
values of good access to healthcare for all!
16

17. The Lisbon Agenda and
sustainable financing of healthcare in the EU
Ladies and gentlemen;
» "I give you EUR 600 billion of additional
economic growth for the EU provided by the
largest service industry on Earth: Healthcare!"
» and at the same time: improved healthcare
services for all!
» and Sustainable Financing for Healthcare
Systems!
17

18. So where could all that money
come from?
The NL 2006 reform provided one essential key: Multiple
insurers, who cannot say No to a patient, secure access to good
healthcare for all.
This provides a clue to the introduction of politically acceptable
ways to allow additional consumption of healthcare services (i.e.
multiple purchasers).
Attractive financing solutions for healthcare services can become
as common as for other expensive consumption items!
Reflect: mobile telephones and communication technology has
”taken” ~5 % of household budgets in 15 years – where did all
that money ”come from”?

19. THANK YOU!
www.healthpowerhouse.com