Healthcare: Whose Responsibility Is It Anyway?

 

In his keynote speech, James A. Rice addressed the question “whose responsibility is it anyway?” by broadening its scope beyond the physician or the government since “it’s of course everyone’s responsibility.” He outlined the need for a whole new response in which responsibility is divided between the nation, civil society (private and public), and the family and individual. He explained that healthcare is not just a question of provision but of who will be monitoring the quality of care, reporting on the performance of institutions, and gathering the necessary resources. Rice also suggested increased attention toward factors that affect health besides healthcare such as nutrition, shelter, and jobs. These external factors further point to the duty of the individual, leading Rice to his assessment that the future of the healthcare debate will focus on government promoting the responsibility of the individual.

 

As Moderator Pavel Hrobon shifted discussion toward patient expectations in the healthcare debate, Jana Petrenko highlighted the public’s deficient awareness of the rising cost of healthcare. Once a citizen is sick, she explained, they naturally want and expect the best and most efficient healthcare. Petrenko therefore emphasized the need to better convey to the public what level of healthcare can be provided at a given cost. This would lessen the great divide between reality and expectations. Additionally, Petrenko urged greater use of patient organizations in the Czech Republic whose importance lies in this very issue of information, consulting as well as helping a patient live with their diagnosis. She describes these organizations, as “a very valuable link in the healthcare system but very often without proper recognition.”

 

Echoing Petrenko’s argument of reminding the public of their responsibility for their health, Rudolf Zajac, former Minister of Health in Slovakia, described the “never-ending demand of patients who have the illusion of free healthcare.” Zajac underlined the responsibility of the patient suggesting better nutrition and more frequent medical check-ups as a means of preventing critical health issues later in life.

Octavian Purcarea offered information technology as a way to promote patient wellness as suggested by Petrenko and Zajac. For example, the “increase in computing power has raised the capacity for rapid response.” Furthermore as the semantic aspects of this technology evolve, it changes the way computers alert physicians with information, affecting how healthcare is provided. Ultimately, these developments enable increased communication between the medical field and the public. In addition to physician-patient communication, Purcarea attached great importance to a healthcare model where patients are given incentives to change their lifestyle.

 

As Pavel Hroboň refocused the question of healthcare responsibility toward values and behavioral changes, Marek Vácha emphasized shifting the public’s focus more toward their responsibility than toward their right to healthcare. He believed that this lack of responsibility is manifest in the Czech Republic where “the number of HIV positive people is increasing in spite of our education.” This tendency to focus on rights rather than responsibility is critical as good healthcare will depend on “refreshing our sense of responsibility.”

 

Rice closed the discussion by urging the audience to assess “how we choose to make decisions about not only the responsibility for healthcare but how we allocate resources to act on those responsibilities.”