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As featured on BusinessMirror:  Champions of change: How governments can lead healthcare transformation


While virtually all countries have at times struggled with their response to COVID-19, the global pandemic and the public’s belief that their government should keep them safe has also provided governments with opportunities to show they can be agile, innovative and outcome-focused. Profound decisions – curfews, lockdowns, the imposition of public health practices such as wearing masks, and eventually the rollout of vaccine programs – have been made in response to real-time data.

Regulations have been changed or suspended to facilitate emergency-use authorizations for vaccines, allow staff to be retrained and redeployed, simplify data sharing, and support the introduction of new digital tools. Partnership with the private sector has enabled services to move online and the rapid development, trialing and manufacturing of vaccines.

The pandemic has forced governments to reconsider every aspect of their healthcare systems. This includes workforce size and shape, digital infrastructure, disease surveillance, research, supply chain speed and resilience, access to care, data use, regulation, and service integration. It has also re-ignited the debate about factors contributing to poor health such as overcrowded housing – which encourages the transmission of COVID-19 – and conditions such as obesity which have significantly increased the risk of death from COVID-19.

What Role Should Government Play?

In pursuit of a healthcare future that is digitally enabled and person-centric, governments will need to take the lead as enablers of innovation and partners in transformation. Regulatory flexibility, investments in technology and people, and supporting the right public and private sector partners will allow governments to become transformation catalysts.

Digitally enabled healthcare is by no means the preserve of wealthier countries. On the contrary, developing countries pursuing universal access to healthcare are increasingly looking to the reach and economies of scale offered by digital to provide services at a far lower cost than would have been possible without networked technology.

Since healthcare is a core political issue, there is a temptation for governments to create prescriptive plans for its structure and delivery. But the speed and complexity of changes in technology, attitudes and expectations mean that any rigid scheme faces rapid obsolescence.

Governments that do not have direct responsibility for providing healthcare should:

  • Set system values such as social solidarity and the right to affordable healthcare, quality standards, and goals such as expanding access or ensuring adequate mental health services.
  • Establish rules on pricing and the confidentiality of patient records and create environments of innovation that ensure the supply of an agile, adaptable workforce.

Levels of government funding and its distribution have profound effects on the scale of healthcare and how systems behave. Traditional fee-for-service payment models incentivize the volume of care instead of quality, driving up costs and undermining productivity. In contrast, incentives to manage population health and focus on outcomes are more likely to support healthy behavior among the public and ensure value for money. Financial incentives can also be levers for new forms of care which improve access or quality, such as virtual consultations, by adding them to reimbursement schedules and providing subsidies.

Regulations can likewise promote or inhibit quality improvements and care transformation. While setting professional practice limits helps ensure quality and safety, prescribing rigid boundaries between professions can prevent staff from making full use of their skills, perpetuate outdated ways of working, and inhibit multidisciplinary teamwork.

Beyond the healthcare system, governments must understand the impact of factors such as housing, education and employment on people’s physical and mental health. There is now a substantial body of international evidence that the conditions in which people are born, grow, live, work and age are key determinants of their health. The social determinants of health are in turn influenced by drivers such as the way the economy works, the distribution of power, gender equity and societal values.


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This article is for general information purposes only and should not be considered as professional advice to a specific issue or entity. The views and opinions expressed herein are those of the author and do not necessarily represent KPMG International or KPMG in the Philippines.