[APAC Heart Summit 2024] Experts call for efficient healthcare spending to fund cardiovascular care

BANGKOK -- By Kim Ji-hye/Korea Biomedical Review correspondent -- When people hear the word “finance” in the context of healthcare, images of numbers, taxes, and spreadsheets often come to mind. But what if it wasn’t about the numbers at all? What if the significance lay in how those figures were used?

At the Asia-Pacific (APAC) Heart Summit, held over a steamy weekend in Bangkok, Thailand, Kwon Soon-man, professor of health economics and policy and former dean of the School of Public Health at Seoul National University, stated that “improving efficiency in healthcare spending can generate substantial funding without the need for additional resources.”

Kwon made the case that by optimizing its healthcare practices—through better consumer choices, enhanced provider efficiency, and streamlined services—Korea could unlock substantial funding for cardiovascular disease care.

Yet the response from medical providers is often skeptical: “We’re already doing our best; there’s no room to cut costs,” many claim. Kwon challenged this notion during a panel discussion on sustainable financing for cardiovascular disease on Friday, insisting that inefficiencies still exist and must be addressed.

“We frequently waste resources,” Kwon said, urging stakeholders to address this issue. Only by confronting these inefficiencies, he said, could the healthcare system make real progress.

Kwon advocated for a shift towards public sector financing in the APAC region, which includes countries like Japan, Australia, and Thailand, where universal health coverage has been achieved through various public funding mechanisms. These systems, relying on taxation or mandatory insurance contributions, “enhance bargaining power for both consumers and providers, ultimately leading to more equitable healthcare access,” Kwon said. 

For high-income countries like Korea, universal health coverage is already a reality. But Kwon warned against complacency. While countries like Indonesia are close to achieving universal health coverage, others, such as Turkey, still face challenges. In many low-income nations, high out-of-pocket expenses exacerbate health inequities.

Even within countries that boast public healthcare systems, long wait times push patients to private care. Malaysia, often praised for low catastrophic health expenditures, struggles with delays in critical procedures. One patient needing coronary artery bypass grafting had to wait 12 months and unfortunately did not survive that delay. 

This tragic case raises an essential question: what is the true cost of achieving accessibility?

Malaysia and Thailand, with their tax-based healthcare models, have emphasized preventive care and primary health services. The latter, with its National Health Security Office, has established local health funds as part of its universal health coverage scheme—one that empowers local communities to shape their own health strategies.

Walaiporn Patcharanarumol, director of the global health division at Thailand's Ministry of Public Health, explained during the panel discussion how Thailand’s model emphasizes shared responsibility. “We’ve pooled our resources in a way that empowers local communities to tailor health strategies to their specific needs,” she said, describing a culture where every community has a voice.

Korea, by contrast, has a strong infrastructure for high-cost services, but according to Kwon, there’s a pressing need to enhance primary care. “We’re great at expensive surgeries like coronary artery bypass grafting,” he admitted, “but what we need is a balanced approach to healthcare financing.” 

Both Malaysia and Korea recognize the necessity of fostering public-private partnerships to optimize healthcare delivery. “It doesn’t make much sense to focus solely on care within the public sector while neglecting the private sector,” said Muhammed Anis Abd Wahab, head of the department of quality assurance at Protect Health Corporation Sdn. Bhd., which operates under Malaysia’s Ministry of Health, during the panel discussion. He noted that Malaysia is actively working to establish such collaborations.

Wahab added that effective health financing goes beyond generating revenue: “It’s about strategically allocating the scarce resources we have,” he said. “By closely monitoring the quality of services in both the public and private sectors, the health ministry can ensure taxpayer money is used wisely and efficiently.”