Charting a course to remodel Universal Healthcare in the Asia-Pacific
The Asia-Pacific region is facing an outdated healthcare system. How can it be improved for future populations? Image: UNSPLASH/Victor He
Chris Hardesty
Visiting Lecturer at the Global Business School for Health, University College London (UCL)- The Asia-Pacific region is home to about 60% of the world’s population.
- A new model of healthcare termed "Universal Health Coverage 2.0" (UHC2.0) could be more sustainable and maximize resources for future populations in the region.
- UHC2.0 offers better health standards and could be achieved by using the three care pathways life-course immunization, diabetes management and rare diseases.
Although Asia-Pacific region is home to some 4.3 billion people, its healthcare delivery and financing models are outdated. They do not address challenges the region faces, such as the rise in communicable and non-communicable diseases and ageing populations.
There is an urgent need to increase efficiency, optimize resources and improve patient outcomes. It’s incremental to ensure a shock-resilient healthcare system.
To maximize resources and enable sustainability through creative strategies, a new model of healthcare, termed “Universal Health Coverage 2.0” (UHC2.0) has been proposed by a core research team comprising the World Economic Forum, KPMG and Sanofi.
UHC 2.0 embeds care and well-being as standard operating procedures at all levels of society. Delivery and financing models must be reformed for future populations.
Here are 3 actions each to pursue in sustainable healthcare delivery and sustainable healthcare financing to achieve better standards, by using three care pathways – life-course immunization, diabetes management and rare diseases – as they reflect the most pressing healthcare needs of the day.
Delivering sustainable healthcare
- Infrastructure: less on the physical, more on the virtual
To adjust to the shift in the demographic and epidemiological make-up of societies, the UHC 2.0 infrastructure should focus on patient experience, effective allocation of resources and sustainable access to safe, equitable intervention through technology and data.
Government leaders in APAC should draw on the rapid expansion of network access in their countries to address the rising demand for healthcare needs. Mobile devices, wearables and apps can revolutionize disease awareness, diagnosis and management.
Access to health records through digital apps could empower individuals to engage with personalised healthcare.
In APAC – where cultural norms and patient perception of their doctor’s authority tends to lead to more passive patients – such empowerment could transform patients into active participants in their healthcare decision-making.
- Capacity: beyond development, UHC 2.0 requires us to operate at our upper-limit thresholds
Building infrastructure and increasing capacity go hand in hand, therefore data capture rates must be expanded and improved.
Similarly, upskilling general practitioners by increasing their training and knowledge is paramount. Training stints between countries and regions and optimizing their skills to identify rare disease play a vital role in this.
Public-Private Partnerships (PPPs), such as partnerships between rare disease organizations, and intergovernmental or regional institutions would also be beneficial.
PPPs also include schemes and plans, such as social insurance or legislative change. They support the implementation of initiatives and national plans for rare diseases.
- Consumerism: if we do not change behaviors now, nothing much else will matter
Closer collaboration among APAC countries is key to approaching healthcare delivery gaps. This would help streamlining resources and enabling patients through wider care access.
For instance, patients’ test results could be sent out to regional centers of excellence for further diagnostics. To fund the hefty initial investments for this, medical tourism could be employed.
But, for such initiatives to succeed, a series of carrot-and-stick policies are required.
Financing sustainable healthcare
- Life-course Immunization: the UHC 2.0 intervention solution that pays for itself
Life-course immunization is a preventive approach that will pay for itself. It’s extremely beneficial in preventing further illness and in reducing the strain of ongoing illnesses.
One example of this is the Vietnamese government’s collaboration with the private sector to offer HPV vaccines at a discounted rate to encourage greater uptake. This approach proved successful and resulted in a high acceptance of the vaccine within communities.
Governments can also collaborate with the private sector to increase vaccine access and utilise capital market surpluses i.e. Social impact bonds (SIBs) which naturally promote ecosystem collaboration.
Social impacts bonds (SIBs) are a good vehicle to increase preventive healthcare.
- Diabetes Management: a circular prevention-treatment that makes for productive investment
Prevention plays a significant role that needs to be recognised. For example, increased investment in routine screening, primary care and healthcare literacy will provide benefits, even if the number of those with diabetes rises sharply.
Diabetic management financing through higher corporate philanthropic efforts as well as SIBs are rising in popularity.
For example, Japan’s SIB programmes for healthcare saw involvement of major banks as investors e.g. SMBC and Mizuho Bank. This indicates SIBs as viable social investment for mainstream investors.
A mix of system and individual-level incentives must be deployed urgently. Accountability can be repaid via spin-off benefits accrued to each stakeholder.
Once preventive behaviors take root, funds can be shifted towards treatment patterns, such as adherence to insulin intake and glucose monitoring.
- Rare Diseases: investment in a few spells a positive return for the masses
One finance option for rare disease is the adoption of instalment-style schemes involving multiple stakeholders throughout the public- and private-sector value chain.
A pan-regional model for financing rare disease schemes is also being explored. Potentially, the goal is to standardize the rare disease matrix to define the types of illnesses.
This includes focusing on their respective treatment needs, establishing a more consistent care package and setting up legal frameworks for sharing resources and data among countries.
Crowdfunding is another legitimate financing channel which is already being implemented globally. Tax incentives and sin taxes are further options, although these are only sustainable if they come from multiple sources rather than a single source.
Unlocking the potential of healthcare sustainability now
Making a change to such an entrenched system is no easy feat. Yet, it’s not an impossible one. It will require close collaboration between multiple parties and all stakeholders as soon as possible to evoke much-needed change.
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