Symposium at the Brocher Foundation, Geneva, 4-5 July 2013
Speakers: Alex Broadbent, Nancy Cartwright, Michael Marmot, Alfredo Morabia, Justin Parkhurst, Anya Plutinski, Jacob Stegenga, and Sridhar Venkatapuram.
ABOUT THE SYMPOSIUM
Health care financing and provision is undergoing a crisis around the world. In Europe, the cost of medical care are increasing, along with levels of national spending on healthcare. Moreover the rate of increase exceeds the rate of regional economic growth. Something must be done, but it is far from clear what is the right political or social response. In much of the developing world, on the other hand, the situation is the reverse: increases in prosperity, particularly in the BRICS countries, have not been accompanied by significant healthcare investment; or else significant healthcare investment has benefited only a small portion of society. South Africa, for example, has some of the best medical care in the world, but it is not available to the majority of the population, and preventable morbidity and mortality remains shockingly high. And in North America, there are both high medical costs and highly unequal access, something which the present government has spent considerable political capital attempting to remedy. In short, there is very little apparent agreement on how a healthcare system should be organized in order to be effective, efficient, and equitable, despite a near-universal acceptance that health is both morally and economically important to individual and national wellbeing.
Against this backdrop, this symposium is convened to examine the philosophical underpinnings of effectiveness, efficiency and equity. Public and political debate about healthcare reform inevitably focuses on who should pay and who should provide. This workshop, however, seeks to address the prior question of what works: what healthcare measures are effective for improving population health, how we know they have been effective, and what evidence we need before confidently deploying them in a given sociopolitical setting. Indeed, much of the tumult surrounding health care reform can only be understood when health policy is seen to share important common elements with other public policies. It is not determined only by scientific evidence, nor must it answer only to that evidence. It is also variously influenced by legal rights, bureaucratic norms, political negotiations, and market mechanism, and it must balance these forces against the scientific evidence for effectiveness. In this workshop we focus on the way scientific evidence fits into this complex sociopolitical setting: how it can, how in fact it does, and how it ought to influence healthcare reform.
In particular, the symposium has the following goals:
- To understand the notions of effectiveness, efficiency and equity as they are and ought to be employed in healthcare reform. Especially, to identify the normative implications of the first two, and to clarify the third.
- To assess the use of systematic reviews to drive healthcare reform. Especially, to bring together the various criticisms of their use, to identify evidence (if any) for their effectiveness, and to arrive at a clear “best practice” recommendation for the use of evidence in healthcare reform.
- To highlight the challenges facing developing countries attempting healthcare reform. Especially, to identify novel ways in which social determinants of health and disease might be managed as part of healthcare reform, and to specify the evidence necessary for such measures.
To register, visit http://www.brocher.ch/en/events/evidence-in-healthcare-reform/