Published in French in Les Echos, 03/04/2013
A Mozart string quartet takes just as long to
play in 2012 as it did in the 18th century. That is why the price of
live performances has not gone down, unlike the price of most products that
have experienced an increase in productivity. This is what economist William
Baumol calls the “cost disease.” This disease concerns services based
essentially on professionals’ time and skills – in the case of healthcare,
doctors, caregivers and healthcare workers in general.
And yet, significant progress
has been made in the field of cancer treatments. Development of surgical
techniques leads to less invasive operations and fewer complications. Digital
imagery, combined with specific markers, makes for greater certainty in
diagnoses and more targeted procedures. The digital revolution in medicine
enhances both the quality and productivity of healthcare. It transforms medical
techniques (digital or robotic imagery), patient care (data analysis to better
target procedures and reduce costs) and access to treatment (sharing medical
images through networks, thus reducing test duplications and the exodus of
doctors from certain regions). Unfortunately, this progress is not always
visible: when a factory worker increases his output by 50% in return for a 20%
raise, statistics show increased productivity. If the healthcare system reduces
the mortality rate of cancer by 50% thanks to a 5% increase in costs,
statistics only show the cost increase. Healthcare is not in the grip of a
“cost disease;” it is suffering from an imperfect assessment of its value! To
solve this problem, we need better to improve the way we measure both the value
of healthcare procedures and the quality and rapidity of treatments at the
national level, and the way we benchmark this value at the European level. Of
course, healthcare cannot be reduced to mere statistics, but it deserves more
than the sole costs numbers.
Furthermore, our country has undeniable
industrial strengths: world-renowned practitioners, cutting-edge research
facilities such as the Gustave Roussy Institute, Inria and the Atomic Energy
and Alternative Energies Commission, innovative start-ups such as Medtech (a robotic
surgery specialist) and world-class production sites and centers of expertise,
such as General Electric’s mammogram equipment production site in Buc. However,
we are not the only ones who want to develop this sector. There is little
chance of France winning this worldwide competition without a truly industrial
healthcare strategy.
This
is particularly true in the field of digital healthcare, where we need a
strategy to develop not only infrastructure, but contents and uses as well.
Regarding infrastructure, the problem has less to do with “technical” layers
(networks or hosting solutions) than these layers’ interaction with equipment
of diverse origins, not to mention change management to bring hospital professionals
on board. When it comes to content and use, France rolls out four times fewer
digital imagery systems than Denmark. We are closing the gap thanks to regional
“cloud” projects, but it is essential to continue guiding and encouraging these
projects at the national level.
Rather than “cost disease,” our
healthcare industry is suffering from a two-fold vision problem: it is both
far-sighted, as it has trouble seeing its own advantages close-up, and
short-sighted, as it is unable to make out a long-term industrial strategy that
would help develop its strengths.
