
Well, I know what you are thinking, that is straightforward, the role of the government-funded health system is to keep society healthy.
In an ideal state-funded healthcare system, the goal should be to keep people working, children at school, and the elderly out of hospital. Whilst you may think these goals are the same thing, they are not. If work is the focus, the decisions made are different, and treatment is prioritised with a sense of urgency.
In New Zealand, the Accident Compensation Corporation (ACC – accident insurance) demonstrates the difference between keeping people healthy vs. helping them return to work. ACC is focused 100% on getting people “off their books”, which means getting people back to work, school, and out of the hospital as soon as possible. Their laser focus on this goal significantly impacts the decisions they make in treatment choices. The economics of the ACC are clear, an investment to get people back working is better than someone remaining on their books for potentially the rest of their working life.
The argument against an ACC-style health system is the potentially significant additional investment required, upfront, to have a similar policy in health. This is because the investment is seen in isolation and not connected to the gains in productivity, potential additional tax revenue, and the reduction in sickness beneficiaries. This is understandable as it is impossible to correlate these different measures, but it could be argued that the productivity gains would outweigh many of the additional upfront treatment costs. Without even considering the mental health value of having people well, and living their best lives. We also cannot measure the impact of sick children on parents’ ability to work and be productive.
The importance of work cannot be underestimated. Work is good for us and is important to our mental wellbeing. The Work Foundation [1] in the UK has done research on work and its impact on people's lives. Work is good for us is the overall take-home message.
The return-to-work statistics are scary. According to research, if absent for 4 weeks or longer due to illness, 1 in 5 will not return to work. After 2 years of absence, you are more likely to die than return to work [2]!
Keeping people healthy and working should be one of the government's key goals. Productivity and driving the economy is the only way to increase prosperity for everyone.
[2] https://www.honeydew-health.com/scary-stats-return-to-work/
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