New disease landscapes and increased life expectancy will create different healthcare needs, while research provides new methods and medicines. An overstretched health sector is finding it increasingly difficult to make ends meet.
Over the last century, better medicines, vaccines and living standards have helped Nordic citizens increase their longevity, by around two years every decade. Older people will probably work longer, as manpower shortages lead to a rise in the pensionable age in many countries. Over the next 30 years, the number of people needing care will triple in the Nordic region, at the same time as financing opportunities via taxes become limited.
Public or private health care?
Even today, we can see that private healthcare has become more important in the Nordic countries. However, although private healthcare has grown, public healthcare is still predominant.
The Swedish, Norwegian and Danish public sectors currently cover 82 to 85 per cent of all costs pertaining to healthcare. In Finland the rate is a little lower – there, the state pays 76 per cent of costs and the personal contribution is the highest among the Nordic countries.
Improved technology and greater knowledge
In 20 or 30 years’ time, hospital scans will be routine thanks to ever cheaper magnetic resonance imaging (MRI). This will be advantageous by providing a detailed picture of each patient’s condition. On the other hand, the discovery of a huge number of trifling ailments, with practically everyone being diagnosed as suffering from something, may prove less beneficial.
Thanks to the internet, people are now better informed about their conditions. In some cases, they actually know more than their doctors, leading them to expect more care. Doctors will have to become better at saying no.
What will this cost?
Of course, the major question concerns money. The fundamental rule is that we are happy to pay for someone else’s healthcare when an average level of health, but no more, is the outcome. The state will presumably take care of the ‘basics’ – at least in the Nordic countries – while individuals will have to contribute privately towards anything they want over and above the average state of health.
But it is clear that healthcare will increasingly become more expensive. Source: OECD statistics
Who will pay?
Considering the traditionally low wages and strenuous working environment in healthcare, it is easy to understand the economists’ dilemma: will people and money suffice to handle future healthcare needs?
The fundamental concept of publicly financed and delivered healthcare under the welfare state simply cannot cope with future developments. This can already be seen in Denmark, where more than three million citizens have some form of private health insurance. Their number is steadily growing. Other Nordic countries are traditionally more sceptical towards private healthcare, even though private health insurance is making significant inroads in Sweden and Finland. Only Norway, with its exceptionally strong public finances, seems to be bucking the trend.
In the future, the number of our workforce will fall and people will be older, on average, than before. This is a consequence of general population trends in the Nordic countries. It will lead to greater competition between firms for labour force, and various ways of rewarding and obtaining the commitment of employees will become more important. Similarly, care for the health and wellbeing of personnel will become a key competitive factor.
Could healthcare insurance be the solution?
Firms are more and more interested in various insurance solutions, through which employees' health can be promoted and their commitment to the company secured. Healthcare insurance is one such alternative. For 200–400 euros per employee per year, each employee can be provided with a healthcare benefit worth several thousands of euros. A pay rise on the same scale would have nowhere near the same benefit.
Another major advantage lies in the fact that, since healthcare costs are no obstacle, employees seek medical attention in the early stages of an illness. Overall costs are reduced by beginning the necessary medical treatment at an early stage. Our customers have positive experiences of the effects of healthcare insurance.
What does the future hold?
Most indications show that we are moving towards a future where healthcare needs will exceed public resources. Many illnesses are lifestyle-related and demands on individual responsibility will increase. The question is what we do with the actual content of healthcare. Will we need to change healthcare priorities?