Prof. D-r Rubin Zareski*


In the last 15 years we are experiencing hidden debate where decision makers do not want to opt for the “unpopular” decisions, which need to be taken if we need a sustainable health system on a long run. Lessons from the 2008 crisis and Covid 19 pandemic in 2020/21 have proven that policy decisions driven by external global forces beyond our control, were inconsistent and reasonable damaging also on a short and mid-term. Instead of addressing the core of the problem, in the attempt to reply to the old/new challenges, governments were “fanning the fire”. It becomes obvious that spending more money in uncoordinated way was not solution to the problem. Reducing the cost or expanding the fiscal budgets, both are heavily damaging the share of costs/ benefits in favour of one health area target, further” squeezing” the capacity of the economies to steer up the demand, which has to be driver to the solution and not cause of the problem. Consequently, in a high market developed economies, it become obvious that past cutting of the health budgets especially in primary and secondary care will only temporarily “make up” the state budgets, only until next big health crisis emerges. Due to the sensitivity of the health policies and their complexity (synergies) this will result in overspending in shorth term on problem solving actions, creating structural financial instability of the Funds, both private and State. In this lose-lose situation, with existing misbalances, contracting budgets, increasing demand and sensitive market players responses, there is a high time for redefinition of the Universal access to the health care (UAHC) systems and global policy responses, which will on long term create balanced and sustainable growth of health markets.

Keywords: pharmacoeconomics, health care, new common model, Health Technology Assessment.

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