The saturation of emergencies, medical deserts, the multiplication of patients without a referring doctor, the impossibility of obtaining appointments within a reasonable time, are not specific to France. All Western healthcare systems face these problems. The transition to mass medicine due to changes in behavior and the aging of the population is a revolution to which no country has yet succeeded in providing a tangible response.
The generalization of Social Security has facilitated access to medicine. The use of health professionals became a common act when it was measured forty years ago. The decrease in the remaining charge for households with higher risk aversion encourages them to make more appointments with practitioners.
The increasing proportion of the number of people over 65 which already represents a fifth of the population within the OECD was foreseeable but was not accompanied by an increase in infrastructure and the number of health professionals. The problem is general.
Overcrowding of hospitals
Britain’s National Health Service (NHS) is facing an unprecedented winter crisis, with wait times for emergency treatment even for heart attacks of up to 90 minutes. In Canada, authorities have asked the Red Cross for help to manage the influx of patients in hospitals. In Switzerland, health establishments are also faced with problems of patient management.
All health systems have to deal with an increase in the number of patients with, as a result, an increased number of deaths. In France, the latter rose from 529,000 in 1992 to 667,000 in 2022. This number was only 613,000 in 2019. In three years, mortality has increased by 10% to 25% depending on the European country. .
Strong increase in healthcare expenditure
Health expenditure is rising sharply in all OECD states. They exceeded 9% of GDP, on average, compared to 8% before the health crisis. In France, public health expenditure amounted to 9.2% of GDP in 2021. Already under pressure in terms of the workforce for several years, the covid epidemic has only increased the problem. .
More patients, fewer professionals
For years, Western countries have tried to control health expenditure by limiting the number of professionals (numérus clausus), reducing the price of (generic) drugs and regulating hospital expenditure. Like other sectors of activity, the health sector has to deal with an upsurge in resignations and self-limitation of working hours. More patients and fewer professionals with declining productivity, the cocktail is explosive.
The resolution of the crisis in the health systems will take time, in particular because of the delays in training doctors and nurses. Moreover, in Western countries, the health sector is plagued by compartmentalization and administrative red tape that are difficult to overcome. The covid-19 epidemic has made it possible to move many lines, in particular by involving pharmacists more (diagnostics, vaccinations). Remote consultations with the use of self-diagnosis devices (connected watches for example) should increase in the future to reduce overcrowding in emergencies and practitioners’ surgeries.
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