newsletter medicare - Nov 2016

newsletter medicare - Nov 2016

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  1. World HealthOrganisation (2010) Health systems financing: The path to universal health coverage. World Health Report. 2. Ibid. 3. All WHO Member States have signed up to the declaration of World Health Assembly resolution 58.33 in 2005 and have tasked WHO to develop an action plan to implement the 2010 World Health Report. 4. Millennium Development Goals 2015, United Nations 5. http://www.who.int/health_financing/UHC_ENvs_BD.PDF No one knows precisely when humans started using cash in exchange of goods or services – history claims it was 5000 BC. Are we going to keep using it until the next 7 millenniums? Spoken truth, limited action - Healthcare around the world is unaffordable for millions of people, and the cost of the medical treatments continues to prevent those with limited buying power from seeking care. In parallel, this condition pushes the many into poverty each year after having the access to the right care. Globally, and especially in most of developing countries – where healthcare infrastructure is not well built and fitting to the national community, hardships due to the costs spent on the medical needs, a family financial situation can change almost in a blink of an eye: assets are sold, savings are emptied, children are forcefully taken out of school for not being able to cover the tuition fee, family members give up employment to provide care, and social networks are strained due to unpaid loans and repeated requests for help. Every year, catastrophic health costs push millions of families into intergenerational cycle of poverty1. Only one of five people has social security protection that will cover lost wages in the event of illness2 . Given the fact, countries are responsible for standardizing and delivering universal access to healthcare systems according to their legal commitments for every layer of economy their citizens are positioned. However, many have failed to understand that this is only possible if they develop sustainable health financing mechanisms and infrastructure to support strong and equitable national health systems. Whilst the universal health coverage holds the role as an instrument to realise the healthcare rights for every individual and promote social consistency, equitable (even) health financing systems contribute to progress across all areas of development. Those are the tasks for the governments and world leaders to carryon by prioritising equitable health financing to deliver health for all. Making progress towards universal access to health services is fundamental to go beyond the globalisation to fulfil the healthcare rights and to accelerate social and economic growth. In 1978, at the International Conference on Primary Health Care, world leaders promised to deliver health for all3 , and continue pursuing targets related to global health to achieve the health Millennium Development Goals by 20154 . All efforts combined will continue to fail unless they provide transparent leadership and efficient health financing and equitable health services, ensuring that every individual, especially the vulnerable groups, are protected from costs and risks. What is universal health coverage? Universal health coverage for health is when all people have access to health services (promotion, prevention, treatments and rehabilitation), without fear of falling into poverty5 . When talking about health or medical coverage, one cannot go too far from the cost-perspective of the care services given to the patients. However, it is not the only factor that matters. The financing mechanism that is being used to pay, direct users fees, insurance, tax, crowd funding, or other mechanism that may apply for specific community. The availability of health services, the quality of care and predictability of costs that- will be incurred also influence health care coverage. Thus, in order to develop the universal access to healthcare, the international community must support developing countries to raise funds for health, reduce dependence on out of pocket payments, especially through the elimination of user fees, and promote risk pooling in the form of an increased proportion of public financing for health spent more efficiently and equitably. Believing that healthcare is the most critical human right that effects every layer of economy, government and the environment, our digital hospital concept, MEDx eHealthCenter, is combining the power of technology and analytics to improve the healthcare delivery across the developing countries through its seven care services available on its online platform, www.medx.care. Health Coverage Through Digital Healthcare
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  1 Glinos, I.A., Baeten, R., Helble, M. & Maarse, H. (2010), A typology of cross-border patient mobility. Health & Place. 2 Timmermans, K. (2004), Developing countries and trade in health services: which way is forward? Int J Health Service. 3 Ramírez de Arellano, A. B. (2007), Patients without borders: the emergence of medical tourism. International Journal of Health Services. 4 Turner, L. (2007), 'First World Health Care at Third World Prices': Globalization, Bioethics and Medical Tourism. 5 https://medx.care/about Eindhoven, the Netherlands – the global growth in the medical world specifically, as well as medical technology across national borders have been developed into new patterns of productions and consumptions over the past decades. “A new trend has surfaced. A growing trade in healthcare, involving the movement of patients choosing to cross the borders in the pursuit of medical treatment and health; a phenomenon called ‘medical tourism‘.” – MEDx Care Medical tourism is an act when care seekers opt to travel to different countries, intending to receive – based on personal belief or information sought – ‘better’ medical treatment. The treatments received may span the full range of medical services, but most commonly includes dental care, cosmetic surgery, elective surgery, and fertility treatment. Setting the boundary of what is health, within this range of treatments, not all would be included within health trade. Cosmetic surgery for example, would not be considered within the health boundary. Medical tourism and the globalisation Medical tourists, when being questioned of the reason behind their choice to travel abroad to receive treatments, gave answers that can be based on economic, social, cultural and technological. Domestic health systems in many of the emergent and growth countries, for instance, are undergoing significant challenges and strain – tightened eligibility criteria, waiting lists, non-transparent infrastructures and shifting priorities for health care have mostly direct impact on the care seeker decision making. Others, however, are driven by their stronger purchase power and therefore forms consumerism. The storm of open information era and development of diverse providers competing on quality and price now provide for all demands. Unlike other forms of patient mobility where decisions on behalf of the patient are made by the medical practitioners (doctors or physicians), medical tourism involves individuals acting as a consumer and making their own decisions regarding their health needs, how these can best be treated by the most appropriate provider. There are five driving factors behind the rise of medical service overseas phenomenon found by Glinos et al., (2006): familiarity, availability, cost, quality and bioethical legislation (international travel for abortion services, fertility treatment, and euthanasia services)1 . In terms of familiarity, expatriates often have medical care on their visits back to their home country, which would also show up as medical tourism, for example, the large Indian Diaspora in the UK. Some treatments may not be available or may be subject to a wait in the home country (availability), this may include latest technology and techniques that require more funds to be spent (cost and quality). Or else, treatments that may not be legal in the country of origin (bioethical). Different origin and destination, same purpose Some places may be simultaneously acting as countries of origin and destination in the medical tourism marketplace. High-income countries may service overseas elites from ‘less developed’ countries, driven by the price and quality. Treatments may often be available in their origin countries and equal to the international healthcare standard within the private sector, but at greater cost – often referred as “better developed countries’ medical services are less worrisome, more trusted”. In parallel, the citizens coming from richer, more developed nations choose to travel as medical tourists to Lower and Middle Income Countries for treatments due to lower-cost treatments. This section focuses on the implications for countries from the perspective of them being an origin or source of medical tourists. Example of Medical Tourism advertisement in India. Picture credit to peachealthcare.net There are, though, financial impacts on individuals and their families. Some families may fall into debt to fund treatments. It is also the case that not all medical tourism may consume considerable family resources. All in all, benefits and risks from the medical tourism are applicable to both of origin and destination countries. Most countries that engage in delivering care to medical tourists do so to increase the level of direct foreign exchange earnings coming into their country; to improve their balance-of-payments position (Timmermans, 20042 , Ramírez de Arellano, 20073 , Turner, 20074 ) . To some extent this might be income thought of as accruing directly to the health system. For instance, foreign patients purchase health care services, and hence provide an income that can be used within hospitals to cross-subsidise care for domestic patients, or could be used The Pursuit of Medical Treatments Abroad
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  Click here forregistration to help fund capital investment, such as MRI scanners, that are then used by all patients in the hospital. It is therefore possible that some countries may seek foreign patients in order to develop facilities to better serve local patients. On the other hand, this practice has helped the care seekers mostly in the emergent countries, exposing themselves that there are actually other chances for them to be treated (more) appropriately – the only concern is that not everyone has the privilege to elect their preferred treatments. Current and potential risks from medical tourism Medical tourism as a trend creates risks to the local medical practitioners of the origin countries with more competition of the price, quality of treatments and services, and to the nation’s healthcare credibility. At the same time, international patients also puts more pressure to the destination countries’ medical services with expectations and the limited space available – which was primarily designated for the local patients. Other risk at social level which has been increasing and becoming the governments’ of the destination countries concern nowadays is that patients are refusing to go back to their home countries, claiming their human rights from the perspective of healthcare, and trying to become “permanent residents” to gain equal rights as the local citizens. Combining the phenomenon and what it means to the international society, MEDx Care, as the pioneer in the digital hospital market, provides the care seekers with first and/or second opinion from medical professionals across the border3 , without actually spending extra pennies to seek for the treatment abroad – unless advised the otherwise.