This implies that health is bidirectional. That changes everything about the current healthcare model where we wait for the patient to fall sick, then attempt to treat and nurse the patient back to health. This is a -1 to 0 model, a repair shop.
If we see good health as a positive health state, then we move to a -1 to +1 model, a model that justifies and encourages investments and actions to bring health from a start state of zero to a positive value.
Episodic care works up to a certain degree. But as the population ages and their health needs become more complex, coupled with growing affluence and higher expectations, episodic care looks more like the poorer cousin of holistic, integrated and person-centred care.
Integrated care has been around in Singapore for more than a decade. But its status is that of a “good to have” ideal. Like how we aspire to see Singapore play in the World Cup – it creates a lot of excitement and energy, but the majority do not take it seriously. And when it does not happen, nobody is too disappointed.
But a population health system, if designed and architected right, makes care integration a cornerstone of the entire system. Preventive care and end-to-end care make sense when the organisation is responsible for the health of that defined population, and there is clear joint ownership of health in a system where interests and incentives align.
The organisation would then invest in value, strong relations and interventions that would yield the most health returns for the population. It will incentivise healthcare providers to design and deliver their services to meet population health needs and objectives. We would want to have a population that stays healthy for longer, and when ill health occurs to address it in a timely manner before it worsens.
SHIFTING TO POPULATION HEALTH MAKES A CHOICE FOR ALL
Shifting Singapore’s health system to a population health system is choosing for everyone and enables all to make healthier life choices. It is like tackling air pollution where regulatory decisions help everyone benefit from clean air. There is little reason why the public would say no to a well-designed population health system because we would be the beneficiaries.