THE NEXT GENERATION of HEALTH REFORMS
Three years ago in a OECD Health Ministerial meeting, everyone accepted the statement on the criteria for next health reforms. Now, 3 years later, we can confirm that nothing happened about it.
Inside the document there was also a recommendation on health data governance. And the same, nothing happened.
That's it, an extraordinary built narrative that leads to nowhere. Death and taxes remain as only truths.
Health at a Glance: Europe 2020. STATE OF HEALTH IN THE EU CYCLE
Health expenditure as a share of GDP, 2019 (or nearest year)
The Myth of the Entrepreneurial State
Some delicious words by Deirdre McCloskey on Mazzucato recent contributions:
Mazzucato, a loyal daughter of the left, is suspicious of private gain, of the sort you pursue when you go shopping, say, and is therefore suspicious of people doing things for a private reward. She wants the State, advised by herself, to decide for you. Yet the private entrepreneur, she would concede, gets a reward if she pleases her customers. And it is in fact what Mazzucato in her own trade has done. She has parachuted herself into the center of the debate about the role of state planning as against private profit-making for innovation and allocation. It is not because she is innovative herself (though that is what her brave rhetoric suggests), but because she is, market-style, giving people what most of them want: magical thinking, mythical certitude, free lunches all around, wise and loving parents guiding the people in a coerced routine from on high. Modern “statism.” Her theory is the illiberal one that has dominated economics since John Maynard Keynes eight decades ago spoke out loud and bold.
The statists imagine that it is always COVID-19 time, for anything: the legitimate actions by a State to suppress a plague or a forest fire or a military invasion are to be applied to all manner of private matters, always, with no such persuasive claim to legitimacy as fighting plagues, forest fires, or invasions, being technically speaking public goods. Braiding hair for a living is to be regulated by the State. Innovation and allocation, says Mazzucato in particular, are to be socialized.
And we could say that Deirdre is a loyal daughter of the right. And no problem. However, you may imagine what follows...in her book. I have read Mazzucato and part of her arguments are convincing. However, there is a need for a balanced perspective according to the current trends. Deirdre provides such perspective. A book that deserves to be read.
Charisma and Disenchantment: The Vocation Lectures
For Max Weber:
The professor and the politician are not figures to be joined. Each remains a lonely hero of heavy burden, sent to ride against his particular foe: the overly structured institution of the modern mind, the overly structured institution of the modern state.
The politician needs to convert effort into effect, to “make an impression” on the world. But there’s a fine line between molding the world into a shape and needing to see one’s signature at the base of it. The politician is always at risk of swapping out “actual power”—power tethered to purpose—for “the brilliant appearance of power”—power untethered from purpose. The first is the aim of the true politician; the second, the temptation of vanity, which is “the deadly enemy of any commitment to one’s goals.” When a politician gives in to vanity, amending or adapting his aims in order to perform effectiveness, his power is drained of its design.
The spectre haunting Weber is neither bureaucracy nor capitalism (although capitalism does play an under-remarked role in these lectures). Instead, it’s an ancient tension between hero and fate, transposed to modern life. Where classical tragedy sees the hero felled by a destiny that he resists, the nemesis of the Weberian actor is absorption in the institutions that he’s meant to oppose. Society is a siren, forever tempting us to forsake our tasks and seek the smaller goods of reputation and status. The scholar becomes a scribe; the politician, a hack. The danger is not defeat of the opposing self from without but corruption of the self from within, where the self’s diminishing desire to oppose comports all too well with society’s needs.
Great op-ed by Corey Robin at The New Yorker.
Framework for Equitable Allocation of COVID-19 Vaccine
Health equity is intertwined with the impact of COVID-19 and there are certain populations that are at increased risk of severe illness or death from COVID-19. In the United States and worldwide, the pandemic is having a disproportionate impact on people who are already disadvantaged by virtue of their race and ethnicity, age, health status, residence, occupation, socioeconomic condition, or other contributing factors.
Framework for Equitable Allocation of COVID-19 Vaccine offers an overarching framework for vaccine allocation to assist policy makers in the domestic and global health communities. Built on widely accepted foundational principles and recognizing the distinctive characteristics of COVID-19, this report's recommendations address the commitments needed to implement equitable allocation policies for COVID-19 vaccine.
If vaccines are coming in the next months and we all agree that supply will not fulfill demand, then we need to prioritise. This publication of the National Academy of Medicine provides some usegul insights. However, the most important is to have a concrete application in specific contexts.
Better Now. SIX BIG IDEAS TO IMPROVE HEALTH CARE FOR ALL CANADIANS
Morris Barer and Bob Evans first coined the term “health care zombies” in 1998. A health care zombie is a terrible idea about health care that refuses to die. No matter how many times you drive an evidence-based stake through its heart, it rises from the (un)dead to confront you in the newspapers of the nation, ruining a perfectly good morning cup of coffee.
These ideas have often been proposed as solutions to the pressures on our health care system. But they’ve all been shown, time and time again, to weaken health care quality and sustainability. They also undermine our shared values.
These words sound familiar in our context. However it comes from a canadian book.
A canadian physician reflects her views in a well written book about the health reform. It says:
When care is necessary to improve health, every Canadian deserves reasonable access to it. That means solutions to wait times that help everyone, not just people who can afford to pay for their care. And it means finally bringing medicines under medicare. Across the country, people like Ahmed the taxi driver are forced to sacrifice their long-term health because of the short-term crunch of prescription drug costs. Alongside that profound inequity lives the uncomfortable truth that we pay some of the highest prices in the world for our prescription medicines. Only our governments can take the necessary steps to establish a national pharmacare program that would ensure access, safety, and appropriate use of medicines at a cost that is affordable not just for governments, but also for citizens and for employers.
It is quite incredible that canadians don't have drugs in the benefits package. And this is the outline of the book:
THE BASICS
Dr. Martin Goes to Washington
Getting Our Facts Straight
Taking the Pulse of the System
Health Care Zombies
BIG IDEA 1 Abida: The Return to Relationships
Primary Care: When It Works, It Works
Three Relationships for Health
Rewarding What Matters
BIG IDEA 2 Ahmed: A Nation with a Drug Problem
Medicare’s Unfinished Business
The Price Is Wrong
Prescribing Smarter
BIG IDEA 3 Sam: Don’t Just Do Something, Stand There
The Compulsion to Cure
Slow Medicine
BIG IDEA 4 Susan: Doing More with Less
The Revolving Door of Health Care
What Better Looks Like
The F-Word
BIG IDEA 5 Leslie: Basic Income for Basic Health
Sick with Poverty
Curing Income Deficiency
BIG IDEA 6 Jonah: The Anatomy of Change
From Pilot Project to System Solution
Data: The Brain of the System
The Heart of the Matter
Feet to Do the Walking
CONCLUSION Worthy Action
The US Government Will Pay Doctors to Use These AI Algorithms
The US Centers for Medicare & Medicaid Services (CMS) recently said it would pay for use of two AI systems: one that can diagnose a complication of diabetes that causes blindness, and another that alerts a specialist when a brain scan suggests a patient has suffered a stroke. The decisions are notable for more than just Medicare and Medicaid patients—they could help drive much wider use of AI in health care.
The incentives for technology adoption are related to professionalism, organizational, and economic. In this case are the latter one.Though, FDA must have cleared both algorithms, and this is the case.
We could also think on using AI for reducing radiation exposure in CT scans for example..
EU is lagging behind developed countries in this (and many other issues)...
