Corona - What's up
RWU does not stand still even in these extraordinary days and weeks. In many places new solutions are being worked on with commitment and creativity. With the series "Corona - What's up", we want to focus not only on what is currently not possible, but especially on what's up.
Due to the outbreak of the coronavirus, the German healthcare system is facing great challenges. Professor Dr. Jan-Marc Hodek is Vice Dean of the Faculty of Social Work, Health and Nursing at RWU, and heads the course in Health Economics. He previously worked as an economist at the Federal Ministry of Health in Bonn and Berlin.
Dennis Welge: What can health economics be summarized with and what are its tasks?
Professor Dr. Jan-Marc Hodek: Health economics is to consider health care from all perspectives with the economic view. My area of expertise deals with the most efficient use of all scarce resources. Besides tax and contribution money, this includes medical and nursing working hours. Every Euro can only be spent once and every minute can only be used once for patient care. In normal times we look primarily at the economic efficiency within the health care system. In the current situation, in general of course it is about the interaction between health and the economy. We see and experience this interrelation daily and the news is currently about almost nothing else. I think that the field of health economics is, therefore "crisis-proof" in the literal sense of the word.
Your field is currently the focus of attention. Is Corona changing your view on health economics?
I am confronted with the accusation that the economization of health care, is a problem. Of course, I don't see it that way at all. Economics is about getting the best possible results from scarce resources. Nothing is more topical or right these days.
How would you assess our health care system with regard to Corona?
Looking at health systems with a larger state character, such as in England or Italy, it is clear that these structures are no better off than we are with our more market-oriented approach. Fortunately, German hospital capacities are very high by international standards. The number of 28,000 intensive care beds so far, with about 82 million citizens, provides us with more buffer than other countries have. In addition, further intensive care beds with artificial respiration were set up at very short notice. Just for comparison: Spain, with its 47 million inhabitants, only has 4,700 intensive care beds. In England, there are only about 4,000 with almost 56 million inhabitants.
How do you assess the current development of the German healthcare system?
At the moment I often hear that the wheel of economization has to be turned back. However, this opinion fails to recognize that we would also be giving up a lot of dynamism and innovative strength. If you look at the figures, you can see how efficient and effective the system is. Germany has an exceptionally low corona death rate. We have many intensive care beds, nursing staff, and doctors. Healthcare spending is constantly rising. About 15 years ago, we had four million employees in the health system - today we have almost six. The total volume of healthcare was about EUR 200 billion, now it is almost EUR 400 billion per year.
What would you improve within the German healthcare system?
In my opinion, the basic orientation of the German health system is right. We have an efficient system that works well even under stressful conditions. The last few weeks have shown this, even if great efforts were necessary.
Of course, this does not exclude the possibility that we should be even better prepared in the future. Issues such as stockpiling with protective equipment and disinfectants, laboratory and test capacities, and tracing apps must be addressed and improved.
What is your advice for the future?
In the crisis we are happy for every bed, that's for sure. But permanent over-capacities are certainly not sensible. It would tie up resources; doctors, nursing staff, and equipment that are not needed in normal times would still have to be paid for. I am thinking of a kind of hidden reserve. We need fallback capacities with doctors, nurses, and other health care professionals that we can quickly ramp up in case of a crisis. Similar to reservists in the Bundeswehr, who have a normal job outside of emergency situations- but who can be quickly on standby in a crisis. Such a thing would probably be best described as a "breathing system". Building this is a major task for the future