When I’m reading articles about consumerism in care, it would seem that a global answer to unsustainable healthcare policies should be to apply to healthcare the autoregulation of market policies.

This is probably true for a part of it certainly in a perspective of integrative care.

However we should avoid that by organizing a care system under a fully integrated care service medical needs which should normally be covered by a care insurance are melting away like snow in the sun.

Organizing healthcare services by starting from the patient around a fully integrated care pathway is clearly an added value as the patient will feel comfortable & protected by a care product answering his medical needs, expectations & whishes.

Once this is done, the question is what should be billed to the patient and what exactly will be covered in the future. This question is not so new. Reading Kenneth Arrow article “uncertainly & welfare economic of medical care“, published in 1963, remembers us that healthcare coverage is in a constant balance between market & human right.

However, to start this WE & especially for my Flemish followers, I really liked an interview with Marc Noppen concerning the organization of UZ VUB 2030 plan. It is time toi accept that medical care is a global service dictated by patients’ demands.

But it is important to see one step further.

To avoid future disappointments in pricing & reimbursements, we have to take in account the market reality of care and helping patients & physicians to understand the new rules and prevent them from bad surprises as, for instance, not being covered for day care/hospitalization or for medical care services switched into not reimbursable comfort services realized by other qualified people or new technologies.

My biggest concern is not about efficiency. Most of the care institutions have understood and have the willingness to adapt their organization to answer patients’ expectations in continuity & fully integrated care, offering at the same time to the care institutions reduction of waste, better predictability & cost optimization policies.

My biggest concern goes to the fact that physicians & care givers in hospitals have lost their references and are not prepared to the new rules.

Working day by day with physicians & care givers, the large majority is just terrified of the future as neither the managers, neither the government seem to be concerned about their social responsibility or give them a clear vision of their mission.

Discussion we will certainly continue within BHCT

Karolien Haese