Private medicine is not the answer

The way that health systems are organized, financed and managed is important. Improved performance is critical, even in countries with some of the best life expectancies, and the best health systems in the world. link

The rise of chronic diseases has uncovered further problems. It has demonstrated the burden of long-term care on health systems and budgets. It has revealed the catastrophic costs that drive households below the poverty line.
It has shown us the bitter irony of promoting health as a poverty-reduction strategy at a time when the costs of health care can themselves be a cause of poverty.
Prevention is by far the better option, and this requires behaviour change and coherence of government policies. At the same time, the main risk factors for chronic diseases lie beyond the direct control of the health sector.
In other words, the response to chronic diseases and many other health problems requires efficiency, fairness, and multisectoral action.
The values of equity, social justice, and universal coverage are solidly present in the Tallinn Charter. As the document before this Committee notes, these common values play a central role in health decision-making all across Europe.

The primary health care approach, as articulated in 1978, was almost immediately misunderstood. It was a radical attack on the medical establishment. It was utopian. It was confused with an exclusive focus on first-level care. For some proponents of development, it looked cheap: poor care for poor people, a second-rate solution for developing countries.
After 30 years, primary health care is no longer so deeply misunderstood. The ministerial conference has helped return primary health care to its original meaning. This is a rational approach to fair and efficient, good quality care. And its values, principles and approaches have relevance in rich and poor countries alike.

The Tallinn Charter drew on work that followed the Commission on Macroeconomics and Health. This work showed that health is not a drain on resources. Instead, it is a producer of economic gain.
A health system is not a burdensome money-guzzling duty. It is a strategic opportunity. A health system provides a strategic opportunity to manage health in a foresighted, proactive way. And it provides a strategic opportunity to manage the dynamic two-way relationship between a nation's health and its wealth.

Let us be frank. In most countries, an appeal to the value of health equity will not be sufficient to gain high-level political commitment. It will not be enough to persuade other sectors to take health impacts into account in all policies.
This is why I believe the work being done in this region is so important. You have elaborated a range of policy tools, incentive schemes, and legal and regulatory instruments for improving the performance of health systems.
You have done so based on solid evidence. And you have used some powerful – and persuasive – economic arguments.
Primary health care is quality health care. This is health care that requires resources. This is an approach that must be supported by powerful arguments and persuasive evidence. And this is an approach that requires enormous political courage.

haquim avicena