The real news is why we are not where we might be in three years time

It is easy to write about new developments in telehealth and clever innovative ways of delivering care. But the real news is where we are now in health care services. And that isn’t so good.

Talking to a big Pan-European pharmacy chain I was told that escripts do not exist in Germany or France. So the patient is given a paper scrip by the doctor, goes to a pharmacy, gets the medicine and a bit of paper that he or she then has to send by mail to the private insurer. The lucky statutory insurer or state payor gets sent truckloads of paper scrips to match up.

Or take private healthcare insurers. Yes, yes, they all want to turn into service providers. They want to offer the insured a digital wotsit to synthesise their genetic make up, vital stats and general fitness into a number. The insured can then improve these by going to the gym and taking the right supplements for the results of their genetic testing. And we can layer on telehealth teamed up with AI diagnostics. It is all so cool, isn’t it?

The truth is that private healthcare insurers in Europe and emerging markets are today paying operators a fee for service which encourages over-treatment. Value health has yet to be rolled out. And most insurers have absolutely no idea whether and where their insured are getting quality care. In fact, as far as we can see, outside of North America, they aren’t systematically measuring or rewarding quality at all.

The reasons behind all this – the power of the pharmacist lobby, the powerful position of A-brand hospitals and the privileges of the medical profession. This is the real, current, environment we need to constantly remind ourselves of.


We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.