At a time when universal health coverage struggles under the onslaught of rising costs and budgetary strains around the world, the OECD Ministerial Statement: The Next Generation of Health Reforms of 17 January 2017 offers much needed support to the ideal of equitable access to people-centred healthcare.

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For everyone working in the healthcare sector, 2017 arrives with much to celebrate and a great deal to ponder. On the one hand, we can look back on decades of sustained progress, with universal coverage of healthcare rising and people enjoying generally healthier and longer lives than ever before. Funding is increasing and the OECD’s figures on the state of play show the number of doctors and nurses has grown significantly across most OECD countries since 2000.

Is there such a thing as a right amount of health spending? In an ideal world, this would likely mean spending that achieves effective healthcare services, with good outcomes for patients, the right number of professionals with the right skills, and delivers good value for tax payers with little, if any, wastage. Finding that balance is a difficult challenge. 

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Countries around the world are struggling with rising healthcare bills. Every introduction of pricey new biologics, surgical procedures, and exotic “precision” treatments causes ever-increasing fiscal stress, leading to deficit spending, cutbacks in other government services, and insurance costs shouldered by firms and employees alike. Yet, freezing budgetary allocations is clearly not an option, as citizens in our ageing societies are likely to demand more and better access to new health innovations, and essential healthcare services. What can be done?

Nowhere in the world do women have as many opportunities as men, whether those opportunities are economic, social or political. If we’re going to make our commitments under the Sustainable Development Goals (SDGs) count, we have to start here.

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Every year 1.25 million people are killed and as many as 50 million seriously injured in road crashes worldwide. This epidemic of road injury causes huge economic losses and places severe burdens on public health systems. Fortunately, this predictable and preventable global health emergency has now been given the international recognition it deserves. Road safety is included in the United Nations Sustainable Development Goal for Health, with a target to halve road deaths and injuries by 2020. This provides the strongest possible mandate for urgent action against a scourge that has become the number one killer of young people in all regions of the world. 

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Telehealth is not a substitute for seeing real doctors, but can play a valuable role in patient-centred healthcare and in closing the rural-urban divide as well. But it will require investment and determined policies.

OECD Observer: On the OECD healthcare conference website you paraphrase Donald Berwick: “We are all guests in our patients’ lives”.* What exactly do you mean by this eloquent phrase? 

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The number of doctors and nurses has reached an all-time high in the OECD area. Some 3.6 million doctors and 10.8 million nurses were working in OECD countries in 2013, up from 2.9 and 8.3 respectively in 2000. Jobs in the health and social sector now account for more than 10% of total employment in many OECD countries.

"Even marginal shifts in public policy or human resource design can have a very positive impact on an employee’s current state and healthy retirement prospects."

Dementia is an umbrella term coined to embrace all the chronic brain disorders that progressively lead to brain damage and the deterioration of memory, functional capacity and social relations. Alzheimer’s disease, which is fatal, is the most common form of dementia, representing about 60-80% of cases, according to a 2009 study carried out by the non-governmental organisation Alzheimer Europe.

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People in the OECD area are living longer and healthier lives. Improved lifestyles are one reason, as are better medical treatments. But could the number of doctors also be a contributing factor?

Dementia is a devastating condition for which there is no cure available. Care is costly, financially and emotionally. The cost for health systems is likely to rise in ageing societies. The condition damages the brain, and leads to a decline in a person’s functional and cognitive capabilities.

Countries are not doing as well as they could in the battle against cancer, according to Cancer Care: Assuring Quality to Improve Survival. Cancer remains one of the leading health care challenges in all OECD countries, where more than 5 million new cases are diagnosed every year. 

 

The University of Geneva addresses a challenge for the individuals and for the world.

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Vaccines are one of the most cost-effective means of preventing illness and death, particularly in children. Yet, more than 22 million babies born worldwide each year–four times the number of births in Europe–go unvaccinated, leaving them at risk of contracting, and potentially dying from, vaccine-preventable diseases like measles. 

Until now considered a model in terms of reducing poverty and inequality, Brazil has recently faced the wrath of hundreds of thousands of protesters from across all sections of society, riling up against inflation, while calling for better access to health care, education and other public services.OECD analyst Horacio Levy explains.

You've probably heard that old adage, where someone asks someone else if they “ate lead paint chips” as a child, after they did something stupid or silly. The effects of lead poisoning, however, are not silly. Many academics believe lead poisoning in children correlated to spikes in crime more than any other single factor. Granted, it takes more than a noticeable pattern to establish causality, the meta-analysis of other factors all seem to point in the direction of lead.

Patients in most OECD countries face long hospital waiting times, whether for primary care, out-patient specialist care or even emergency care. Tax payers rightly expect better service, and hospital waiting times are understandably a contentious political issue.

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A recent OECD Recommendation on the Governance of Clinical Trials issued in December 2012 could improve the outlook for fighting deadly diseases around the world. Here is how.

The Internet is much more than a multi-billion dollar industry. The world’s economy now depends on this global “cloud”, which was once little more than a means of connecting different computers over a phone network. Today, the digital age has vast new potential to serve as a force of progress in the global economy, but better, smarter public policies will be needed for that potential to become reality.

Some 83 million people suffer from diabetes in the OECD area. On current trends, that will rise to almost 100 million by 2030. 

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For the first time in decades, health spending has not increased in real terms on average across OECD countries. According to figures published in the latest OECD health data 2012, the growth in health spending in 2010 slowed or turned negative in almost all OECD countries. 

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Emerging economies have made good progress on health coverage recently, but the share of out-of-pocket payments in total health expenditure remains significantly higher than in most advanced countries.

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In 1950, less than 1% of the global population was over 80. By 2050, the share of those aged 80 and over is expected to reach nearly 10% across OECD countries. The trouble is, while people are living longer, they are not always able to look after themselves. Relying on family help can be difficult, not just financially, but also because, as people live longer, their children may also be ageing and facing challenges of their own. That is why public authorities are starting to focus on the issue of long-term care and the provision of services for elderly people with reduced functional capacities.

In the last edition of the OECD Observer we showed how investing in a gas-based kitchen can save lives. The simple water closet can also be a means to good health and dignity, and a source of economic wellbeing, says a new OECD report, Benefits of Investing in Water and Sanitation.

The growing burden of healthcare expenditure on public budgets is hardly a recent phenomenon. For 15 years before the onset of the financial crisis, health spending per capita had been going up by over 4% per year in real terms across the OECD area–much faster than growth in real incomes. Nearly all OECD countries will soon have nearuniversal healthcare coverage–an historic achievement.

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The number of people travelling abroad to seek medical treatment appears to have been growing in recent years. This could be part of a growing global trend.

Until recently, public health authorities and policy makers have largely ignored rare diseases. It is time to afford them higher priority. Here is why.

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