Should drugs cost "their worth"? What is the fair price?

Pedro Rey

 

There is a significant tension between the promise of medical innovation and affordable access to such innovation. The introduction of new drugs on the market at ever-increasing prices is perceived as the main inducer of the uncontrolled increase in healthcare spending in most developed countries, putting the viability of proper healthcare at risk and creating access barriers. This trend, which had been moderated in recent years by the exhaustion of the development of new products through chemical synthesis, has been reactivated with the new biotechnological products. In many countries, not only in less developed ones, the cost of treatment for diseases such as cancer can be unaffordable, either because it falls entirely on the patient or because the public system that finances it cannot afford it. Similarly, when a potential cure for hepatitis C became available recently, even high-income countries found themselves rationing treatment and looking for ways to guarantee access.

The home as a centre for health and social care operations

Jordi Varela
Editor

 

@varelalaf

People, while enjoying independence, receive health care services in accreditated facilities, where professionals work in an appropriate environment and they manage everything that influences the quality of their work: noise, lights, computers, clinical devices, waiting rooms, etc. On the contrary, when people become dependents, their home takes centre stage. It is, however, an alien place for professionals, often with difficult access and full of unforeseen events. The point is that many doctors and nurses prefer not to have to step out of their comfort zone and, probably, for this reason, home care programs weaken whenever there are budget constraints or overly packed schedules.

Technology helps us to be more human

Paco Miralles

"Learning to read is the most important thing that has happened to me in life," acknowledged Vargas Llosa in his speech at the reception of the Nobel Prize. I share his discernment, although I have had some more important achievements. This task is something inherent to the doctor, one of the weapons that help the indispensable humanistic aspect of medicine.

Treat us like adults

Alexandre Lourenço
 

The development of the Portuguese health system suffered, like so many others, from excessive paternalism and over-centralization. Perhaps part of our failures in responding to the covid-19 pandemic lies in these two issues.

Last December, a Spanish friend shared an article from the El Mundo magazine where he gave some inputs: "nos tratam como niños, y nosotros tan contentos." The infantilization of Society - "the NHS will take care of everyone, everything is fine, the warm weather is the only cause for the excessive mortality, the cold weather is the sole cause for the excessive mortality, the vaccines are there and will solve everything" - demotes individual responsibility. Look at the peskiest kids fighting for the first sweets: vaccines. In the face of terrible mortality indicators, it is not so strange to see people's gatherings without any protection at the first ray of sunlight.

A year later, the inability to deploy an effective contact tracing and testing apparatus demonstrates our failure to do more than the routine. As with the ever-forgotten prevention, the system tends to focus exclusively on the conventional cure structures.

Last month, the British Government presented to its parliament the white-paper "Integration and innovation: working together to improve health and social care for all".  The topic is not new, but it is a sign that gives us hope in the middle of a pandemic. It is this kind of discussion that engages citizens and brightens our future.

It is not the millions from the European "bazooka" that will make us better. Persons, their ideas, and a vision that unites them will make us better.  As my colleague said: If the Government wants to engage Society, the first thing it has to do is to conceive us as adults.

Four premises to arrive at the autonomous organization of your team

Pere Vivó

Lack of agility, rigidity, slowness, excess of indicators, contradictory orders, ineffectiveness... are some of the historical and structural pathologies of the health care system, as Salvador Casado pointed out in the post "Primary Health Care Centres management notes".