1 FOREVER HEALTHY The 2020 Healthcare Consumer 3 Executive Summary The future of healthcare in Europe faces many challenges. What is the best way to reverse the increase of chronic disease; how will we meet the needs of an ageing population and will we have enough healthcare professionals given that the workforce is ageing? These challenges also come at a time when there are increasing numbers of new technologies and treatments available, such as eHealth and personalised medicines, which if applied correctly, could help fill the gap and meet growing healthcare needs. The American Chamber of Commerce including politicians, policy-makers, to the EU (AmCham EU) believes academics and representatives that if today’s healthcare model of patient associations and the continues unchanged, there will industry to ascertain their opinions be an unprecedented escalation on what needs to change in the in costs and demand. Given this healthcare delivery system and where anticipated growing demand and opportunities lie. AmCham EU also the shortages of resources, there compared these views against the has never been a greater need attitudes of 1,500 people across to re-prioritise and rebuild health Europe and what follows is a report systems that can drive healthcare that highlights the many ideas that efficiencies and improve the were generated. The findings were well-being of our citizens. Studies also used to develop a list of priorities have shown there is a direct link which AmCham EU believes should between healthcare investment guide European and national policy- and the overall economic health makers in order to provide consumers of a country as well. with affordable, sustainable and innovative healthcare systems in To contribute to the on-going debate Europe in 2020. around the future of healthcare in Europe, AmCham EU interviewed Key findings of this report are 28 leading experts in healthcare listed overleaf. 4 Key recommendations Taking stock of where we are... professionals to meet the evolving eHealth and mHealth, needs to be and where we can expect to be needs of consumers. It will require prioritised to support this change. appropriate training, an increase in Given that the healthcare sector is — Great strides have been made in the number of generalists and an traditionally slow to change, more treatment and care of Europeans expansion of the responsibilities of will need to be done to educate over the past two decades. existing roles to combat this. consumers, policy-makers and — At the end of 2013 though, — Doctors and other health practitioners about the need for healthcare is under significant professionals will need to continually change, what to expect from a new financial and capacity pressures keep abreast of technological healthcare system and how best and these are expected to increase innovations and become more IT to respond to those changes. further by 2020. literate to enhance consumer access — The concept of healthcare — Fundamental changes in the to information and treatment. innovation will change. way healthcare is delivered are — Healthcare systems should not No longer will the focus be on required for Europe to meet this only try to build relationships with blockbuster medicines but rather growing demand. private providers but also adopt on improving the delivery of highly the best practices from the private personalised care. The changing role of the sector to enhance efficiencies, healthcare consumer capitalise on innovation and redesign healthcare delivery. Recommended priority areas — Consumers will need to play a much — Healthcare systems need to change more active part in monitoring, their focus from treatment after seeking information and making The financial challenge an illness has occurred to health decisions about their healthcare. — The financial downturn and promotion and disease prevention. — This will be aided by the ability Eurozone crisis has made the need This requires an emphasis on to readily access accurate, clear to curb healthcare expenditures education on the importance of and timely information available even more pressing. healthy lifestyles. electronically. — Current healthcare funding models — Investment in innovation is needed — Healthcare consumers will be are not sustainable. Citizens will to drive efficiencies, improve expected to manage their own need to make a greater financial productivity and create more health to a far greater extent than contribution towards their patient-centric care. ever before and take responsibility treatment. — Policies and resources need to be for their own well-being. — Efficiency and systemic directed toward improving health improvements will not solve the and IT literacy of citizens and problem alone. Governments must healthcare professionals alike to Healthcare professionals – invest in healthcare and treat it as empower consumers to take more changing roles an opportunity to enhance the well- responsibility of their own health. — Healthcare professionals will being of its citizens and its economy — Healthcare provider roles need to increasingly need to serve as rather than simply a cost. adapt to changes in the delivery mentors to healthcare consumers, system, and healthcare insurers also helping them interpret the best need to change their remuneration available information to make A new healthcare system schemes to adapt to this change in the best decisions about their paradigm is needed focus. healthcare. — As 2020 approaches, healthcare will — Health has to be seen as an asset — There is a growing shortage of become more decentralised - less rather than a cost. That requires healthcare professionals in Europe, care will be delivered in hospitals education and investment to which is expected to become and more will be delivered on an create a healthcare system that more serious by 2020. This will outpatient basis or even at home. can respond to the realities we are require new roles for healthcare — Developing technology, including now facing. 5 Contents Foreword John Bowis 6 Introduction Susan Danger 7 Chapter 1 Taking stock of where we are... and where we can expect to be 8 Chapter 2 The changing role of the healthcare consumer 14 Chapter 3 Healthcare professionals – changing roles 20 Chapter 4 The financial challenge 24 Chapter 5 Healthcare systems – of primary importance 32 Chapter 6 Healthy expectations – looking beyond 2020 38 The 2020 Healthcare Consumer AmCham EU recommendations 42 Appendix I Health consumer survey 2020 44 Appendix II List of participants 45 Appendix III Data sources 46 Appendix IV References 48 About the research 50 6 Foreword John Bowis Chair of the European Alliance for Personalised Medicine When I imagine what 2020 will be like for health policy and healthcare, the key word is responsibility. As the next decade approaches, Europe’s citizens should expect far more to rest on their shoulders when it comes to healthcare. We shall be asked to keep ourselves well for longer through healthier lifestyles and, when we do fall ill, be expected to take on more of the managing of our condition. We shall expect to be briefed on how to do this and we shall expect to be monitored to ensure we are coping; but a real partnership between patients and professionals is what we want and expect. This report details why such a shift hope to keep more of our citizens out These however, require major is both necessary and desirable. of hospitals, which could lead to a changes. If citizens are to take on Our demographics are changing, much better patient experience and the new roles we expect of them, with a rapidly ageing population, enable them to return to a physically there is a major educational mission an explosion in chronic diseases and financially active life. That is why to undertake. If we want patients and continuing scientific research health spending by individuals and to manage their conditions, and development. That places governments is an investment and we need to teach them how. an ever-greater demand on our not just a burden. That may also require that they healthcare systems and means become digitally literate. Even with such changes, I believe we they will become increasingly also need to look at funding. Free Healthcare professionals are already unaffordable unless we encourage healthcare is a cherished principle in under pressure and are in roles that innovation and a better much of Europe but I believe we will are rapidly evolving and will continue understanding among our citizens. have to find new sources of revenue to evolve. The demands we place on I know from my own experience of for our healthcare provision. That them will be different. We will see living with diabetes and a triple by- might mean asking our citizens to them as mentors, steering us to better health and the best treatment. pass that, with initial support, contribute more to its cost. It will I now take for granted my own role in require governments and employers None of these changes will be easy. their management, from drugs and to look at how they can contribute to This report suggests many ways injections to testing and distance not only healthcare but also health we can address what is needed. If monitoring. By making citizens more promotion. Policy-makers will need we succeed, the prize will be the responsible for their own well-being, to understand that healthy people improved and sustained health and we can hope to reduce pressure on mean healthy economies and healthy well-being of our citizens and our our at-capacity systems. We can also environments. national economies. 7 Introduction Susan Danger Managing Director of AmCham EU At AmCham EU we believe that one What needs to be done to make of the most serious challenges we it happen? What will consumers WHAT KIND OF face in Europe today is how to make expect from healthcare in the HEALTHCARE the health and social care systems future? DELIVERY SYSTEM sustainable and more responsive to Throughout this report, we use the SHOULD BE IN the healthcare needs we face in the term ‘healthcare consumer’ to reflect PLACE IN 2020? 21st century.