A couple of weeks ago, Postimees published an opinion article by health expert Ain Aaviksoo on changes needed in Estonian healthcare system. One thing Mr Aaviksoo pointed out was importance of personal responsibility: health damaged through years of bad behaviour will not be fixed by a brief visit to doctor’s, or some days spent at a hospital.
The ideas voiced by Mr Aaviksoo were good, clever and worthy of further discussion. In an interview today, Health Insurance Fund CEO Tanel Ross adds several interesting notions – welcome ingredients as well in the decision-making of tomorrow.
The issue is broader than seen at first glance. On the one hand, better prevention would greatly enhance health decision quality; that would underline the role of health advisers. On the other hand, health care taxes might be even more effective in impacting health-behaviour. In other words: as health-damaging habits will lead to greater costs to restore the body, this should be reflected in the sum paid by the person into common pot.
Both options carry their questions and problems. Firstly, the choice between the two would imply asking ourselves: who/what is the state, in our opinion? A state convincing us to live healthier would paint a picture of a parent who is supposed to guide and direct us. That would contradict the thinking that people ought to know best, for themselves. Directing behaviour through healthcare taxes, however, would enhance personal responsibility.
That’s not problem-free either, as solidarity also comes into play – an idea worthy of support. As hinted by Tanel Ross, in the interview, solidarity is no mere moral term, but has positively impacted national health. Waiving that would be a step towards private insurance – one we would not like to go for. By solidarity in healthcare, people’s options to get to a doctor will be less dependent in his income. A situation more equal is established.
A solution, obviously, would be excises which will not tax consumption but purchasing. Not a piece of cake either: at rising excises, we have tended to be moderate; as compared to lots of other European countries, we have a long way to go.
Probably, the solution isn’t this or that. Rather, a bit of both should be done: boost prevention a bit, rise excises a bit, and invest in quality treatment process – a large part of which would be just pay for doctors and nurses. And, on top of it all, let’s keep the discussion going.