The crisis caused by the COVID-19 pandemic has put great pressure on healthcare systems in all countries, additionally emphasizing the structural challenges that the Croatian healthcare system faces. Creating a financially sustainable and efficient healthcare system was the topic of the virtual conference of the American Chamber of Commerce in Croatia. The aim of the conference was to start a dialogue and encourage the exchange of views of key stakeholders on the financial sustainability and efficiency of the healthcare system, as well as key challenges and proposals for improving the current situation.
The introductory speech was held by State Secretary of the Ministry of Health, Silvio Bašić MD, PhD. He said “Although the healthcare system has come under great pressure in the past year due to the COVID-19 pandemic, we have demonstrated and proven the good organization of the system as well as the strength of the profession and the medical staff. I would dare to say that the pandemic was a kind of a test, successfully passed by the healthcare system. I would like to highlight the credit of health and non-health professionals in the system, as well as the responsible behavior shown by the citizens.”
In addition to State Secretary Silvio Bašić, the participants of the panel discussion that followed were Rina Musić, Director, Merck Sharp & Dohme; Mihael Furjan, President of the Management Board, Pliva Croatia; Jasminko Herceg, President of the Management Board, Medika and Ana Bobinac, PhD, Assistant Professor, Faculty of Economics in Rijeka. They all agreed on the importance of measuring the effects of treatment outcomes, thinking about sources of funding and fiscal sustainability in healthcare, but also a comprehensive reform of the healthcare system that would affect the expenditure side of the system.
Rina Musić, Director, Merck Sharp & Dohme pointed out that for the long-term sustainability of the healthcare system, it was important to establish systematic and continuous monitoring of treatment outcomes. Precisely because of the significantly better treatment outcomes they bring (better quality of life for our patients, early return to work and increased life expectancy), innovative medicines should be seen as an investment in health and economic sustainability, and not just as a cost to the healthcare system.
“Spending on healthcare in the Republic of Croatia is significantly lower as a proportion of GDP when compared to other EU countries. So, in order to have a healthcare system that is sustainable in the long run, we need to improve the sources of funding because it is expected that due to the ageing population, arrival of new technologies and therapeutic solutions, total costs will continue to rise, which is a trend also present in other countries. There is a need to work towards better measuring of actual impacts as well as better management and greater efficiency of the system with the aim of greater user satisfaction. The work of the healthcare system needs to be normalized as soon as possible, because being healthy doesn’t just mean not having COVID-19,” said Mihael Furjan, President of the Management Board, Pliva Croatia.
“The current debt of healthcare institutions towards wholesale pharmacies is around HRK 6 billion, which has brought it to the breaking point of its further sustainability. By further deepening the debt we can expect increased difficulty in supplying healthcare facilities and patients with certain groups of medicines, and in some cases a complete cessation of supply. All EU countries are facing an increase in spending on the healthcare system year after year, which represents a great burden on public finances. However, almost all EU countries allocate significantly more to the healthcare system per capita in comparison to the Republic of Croatia, and payment deadlines differ, but in most cases they are significantly lower than here,” said Jasminko Herceg, President of the Management Board, Medika.
Ana Bobinac from the Faculty of Economics in Rijeka added that the level of healthcare spending in Croatia is considerably lower than the EU average. At the same time, the healthcare system wants to enable patient access to expensive technology and medicines – equal to that in other EU countries. Healthcare expenditure will continue to grow in the future, caused by an increase in the number of chronic patients, an ageing population and further development of (expensive) medical technology. It is time to have a serious conversation about the fiscal sustainability of the healthcare financing system (that is, about the overall and multidimensional consequences of rising healthcare costs on other sectors, as well as about innovations in healthcare financing models in Croatia). Moreover, a completely new focus is needed on economic viability, that is, on the question of what “value for money” we are currently achieving by investing in healthcare and how we can invest money more rationally in the future in order to achieve better treatment outcomes than we have now.
The video from the event is available here.
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