Behaviorálny a experimentálny ekonomický tím MZSR

Sustainable healthcare starts with the citizen, not the patient

We all make health a priority, but we often put it last in our daily decisions. Why is this so?

"On 27 March 2023, I attended the expert forum Slovak Global Network (SGN)where the main topic was whether it is possible to ensure the sustainability of healthcare without the participation of patients. It was fascinating to hear how each expert with different expertise had a different perspective on the same topic."

Financial sustainability of healthcare and patient involvement

are certainly key topics that have a significant impact on the health of the population and the functioning of the health system. However, from my point of view, it is desirable to focus more on a comprehensive solution to the problem.

"If we want to make healthcare financially sustainable and improve the health of the population, we need to focus not only on patients, but on all citizens already within the framework of preventive health. We should not wait for a citizen to become a patient."

The explanation of why we prefer immediate gratification to future gratification can be found in psychology. This phenomenon is called present distortion, also known as present bias. This distortion helps us understand why, for example, people do not want to get out of their rut (status quo) and why they do not go for regular preventive check-ups. In their eyes, a checkup may provide a vague future benefit, while their daily duties seem more important. Thus, this distortion of future benefits causes them to postpone the activity in question.

If the system were set up to automatically account for these distortions (architecture of choice), we would be able to facilitate not only the participation of citizens in preventive check-ups, but also many other activities. There are a number of tools that can demonstrably prevent procrastination and, with a small change in the set-up of the system, can demonstrably deliver the desired results.

What are the possible solutions?

One such tool could be automatic login for the next check-up directly after the check-up or automatic sending of dates for preventive check-ups. The citizen would also be informed about the checkup one week in advance by text message to his/her phone, or he/she would have to confirm his/her attendance by replying to the text message. This confirmation would be followed by a certain form of commitmentwhich would help the citizen to bridge the gap between his good interest and the desired action (so-called. rozdiel medzi zámerom a činom).

Based on the above example, as well as the results from our projects, we can see that choice architecture has a significant impact on individuals' decision-making and can help increase their engagement and involvement in social activities, including healthcare. We will discuss the impact of choice architecture on increasing citizen participation in healthcare in subsequent blogs.

Girl jumping over a cliff

What we should not forget

Last but not least, it is essential that the health system is accessible and equitable for all citizens, regardless of their social and economic background. Greater citizen participation can lead to better health of the population and improve the financial sustainability of the health system. However, in order to achieve this, we should take into account the overall context of the issue and look for tailor-made solutions that are effective for all groups of citizens.

About the author
Ing. Lukáš Sekelský, PhD.

He works at the Ministry of Health and leads the Department of Innovative Approaches in Health, which consists of the Behavioral and Experimental Economics Team (BEET). In this capacity, he leads various projects in areas such as integrated care, mental health, drug policy, blood donation and others.