article published in NOW, 21 April 2011
We must recognize the difficulty and merit politician who has managed to lower public expenditure compared with the periods of prosperity and good times. The challenge today is managing the budget of Health of the Catalan government, no doubt, has not had any minister since in 1981 he received the transfer of services. Must do more with less, leaving the false rhetoric that thinks more like hiding in the drawer and pass bills next year and passing them to take action based on clinical criteria and health outcomes. There are duties
efficiency improvement and rationalization of public health that have not done it when the economic boom would have been simpler. The responsibility is all far beyond those who have ruled. This includes all income recipients of health (from suppliers to hospitals with medical supplies and prostheses, to pharmacies, rehabilitation centers and ambulances), all without forgetting the last day on which patients act as if Health care was free.
In separate Catalan public health and to explain very well to doctors, nurses, pharmacists, patients and payers that are measures of shock almost forced to come alive id'exercici ends meet financially and what measures should be structural. The excuse of urgent measures shock does not justify the lack of effort and imagination that represent responses that only unionized civil servants and almost closing beds and operating rooms know that or not (still?) Having operations in afternoon public hospitals.
would be more useful to hear what measures are taken center to center and hospital to hospital to make spending cuts a fit patients' health looks the least possible commitment. Rationalization measures are still missing, instead of closing services and operating rooms because they talk about reducing avoidable hospital admissions and readmissions of older people with chronic poorly controlled and increase their years? or the use of drugs beyond the indications of abuse or misuse of drugs and complications that costs and even lives?
need to short-term financial pressure not already postponed the adoption of more structural changes. Do not expect more reports of experts who serve as an excuse and stored in the drawer. We do not have enough already on the table of policy makers? What is needed is political decision and the more successful based on the knowledge available, the better. Measures of management services, waiting lists, management prescriptions and so on. are available to managers autonomous. Those are national, not be avoided, you need to do is put them in the Interregional Council table. There
sufficient knowledge and experience both internationally and in our own country for not postponing action prioritization and selective funding of benefits, both those already pay today as the day they enter in our health without making much noise but with a high cost. The benefits to be paid by the public health system must be chosen in any way you can pay all free and this would continue throwing money and lost years of life.
financing of benefits has give priority to those who have demonstrated their ability to objectively improve health in relation to its cost, according to the cost-effectiveness. Who says this is theory, just tell him to mind, with respect, but firmly, that it can not be so ignorant, unless you want to promote interests that should be explained. If imagination fails
policy, health services research offers an extensive instrumental measurements where possible and appropriate choice in times of recession like this. Recently, a group of renowned researchers in health services and health economics have identified one hundred in the journal Gaceta Sanitaria.
For if there is serious willingness to make decisions, including the first six steps of the list are the following: to control corruption and political leadership; terciarisme reorganize according to volume, results and costs; rethink prevention activities that do not add value, prioritize in emergencies, explorations, tours, speeches, waiting lists ...; involve patients in self-care, define the service portfolio based on evidence.
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