The economic effects of prevention are indisputable. Prevention reduces system costs, helps allocate resources more efficiently and promotes innovation. And last but not least, it increases labour productivity, with workers absent less and working more years. Speaking at the Healthcare Daily’s Economics of Prevention conference, Aleš Rod, a member of the government’s National Economic Council, said this. And among other things, he spoke about effective ways to raise resources for prevention.
„In the current conditions of economic development – and especially public finances – the topic of healthcare, which is increasingly one of the main pillars of expenditure, will be intertwined into the considerations of how to make the system more efficient,“ outlined Aleš Rod at the beginning of his lecture in the first panel of the Economics of Prevention conference entitled Prevention of Health Risks – Concordance or Discrepancy of Stakeholders. He added: „In the National Economic Council of the Government, prevention is one of the basic points we pay attention to.“
There are several economic effects, but the most important one, according to Rod, is certainly the reduction of health system costs. Prevention programs reduce treatment costs through early detection and intervention, but they also provide an opportunity to „play“ with insurance costs. Another economic effect of prevention is increased productivity in the labor market, which feeds into demographic trends. Effective prevention in healthcare leads to increased work efficiency, with workers having fewer absences and working more years. Prevention also has the positive economic effect of better and more efficient allocation of resources. „Prevention programs allow hospitals and clinics to focus on more serious problems and also to better plan public health policies – for example, by working with data, setting measurable goals and evaluating them,“ Rod explained. He said the social benefits and improving the quality of life for all social groups, as well as supporting research, technology innovation, are also essential from an economic perspective for prevention.
Educate from an early age
Aleš Rod also spoke at the conference about how to raise resources for prevention in the health sector. „Of course, effective prevention programmes require a lot of money and there are many ways to get it, both in theory and in practice,“ Rod said. He said the most common way to raise resources for prevention is through public funding and tax incentives. In this context, he mentioned that considerable excise taxes collected from the „addiction industry“ flow into the state budget. „And it would be a good idea to channel them directly into prevention programmes. But as an economist, I have to add that maximising the purposes of the taxes collected is not a policy that is entirely to the liking of the people managing public finances – so it is not easy either legislatively or fundamentally,“ Rod pointed out, who considers the data-based principle of risk reduction, or harm reduction, to be more effective in the field of excise taxes. „And I am glad that the Czech government has put this principle in its programme statement,“ Rod said.
At the conference, Rod also presented a concrete foreign example of the impact of health risk reduction policies. „In the UK, the nicotine inhaling products regulation policy was adopted in 2015, which set the path for the ways in which people will consume nicotine,“ Rod said. In 2007, Britain had a prevalence of daily smokers of almost a quarter of the population. While there was a slight positive trend, it was not fast enough. „A more fundamental change occurred just after 2015 following the application of policies that were a combination of regulatory legislative restrictions, including tax, but also public health campaigns and special programmes that targeted particular social groups, such as expectant or current mothers or people with comorbidities,“ Rod explained. The call for people to quit smoking, and if they can’t and those people can’t, to at least consume nicotine in less risky ways, has caused the use of conventional combustible cigarettes, which carry significant health risks, to decline since then, while the use of e-cigarettes has grown. This is also shown in the graph below:
According to Rod, offering tax incentives as well as public-private partnerships and investment in education, at all levels, are also effective ways to raise resources for prevention. „We should start from pre-school age or in primary schools, explaining to children that how they eat, how they move or how they sleep will dramatically affect their later health,“ the member of the government’s National Economic Council warned. He added: „And, of course, we need to speak to them in a language other than that of the health insurance companies‘ manuals for their insureds.“
Other pillars of raising resources for prevention, according to Rod, include social bonds and conditional grants, such as subsidy incentives or performance-based grants, as well as the use of technology (such as telemedicine), sharing and working with data, market-based approaches to regulation, and retrospective evaluation mechanisms.
Don’t start all over again on a greenfield
According to Aleš Rod, the domestic healthcare system must be perceived as having a dual role. The first is that it is an important pillar of the quality of life in the Czech Republic. „The overwhelming majority of Czechs – either out loud or at least internally – realise that healthcare in the Czech Republic is of extremely high quality and almost everyone has access to it,“ Rod told the conference. At the same time, he said, it is necessary to talk about the second role of the domestic healthcare system – that it is one of the main pillars of public spending by the state. „Healthcare costs are approaching CZK 500 billion a year and, given the demographics, they will rise every year,“ Rod warned.
That is why, according to a member of the National Economic Council of the Government, it is necessary to focus on prevention, which is „one of the basic building blocks for generating sufficient resources for other forms of treatment, for effective work with data, and for the necessary investments and innovations in the health sector“. But this can only be achieved, according to Rod, if health policy plans actually effectively transcend one policy cycle. „That the four-year policy cycle, which very often sees a change of leadership in the health ministry, will not start on a green field. That these people will be operational managers, not people who will rewrite everything,“ Aleš Rod concluded his reflection.
Jakub Němec
Photo by Radek Čepelák
We would like to thank the General Health Insurance Company, National Sports Agency, RBP, Health Insurance Company of the Ministry of Interior of the Czech Republic, Military Health Insurance Company, EUC Medical Group and Sprinx for their support of the conference.
