Medical knowledge and technology is rapidly developing in our part of the world, with new treatments and diagnostics from new and improved medicines. At the same time, the pharmaceutical industry is more aggressive than ever, and through their marketing and advertising we are reminded of the frailty of our health, independent of our health conditions. The industry creates a need for effective and easy treatments for illnesses we might get in the future.
This development has caused a rising demand for health care. The increase is larger than what seems to be the possible supply within a publicly funded health care system. The result of higher pressure on efficiency and stricter priorities has been that the doctors have to make decisions on the patient’s needs. Each patient’s needs must be valued against economic regards. This places the doctors in difficult positions. What is a need? Are we born with these needs, or do we create them ourselves? If not all demand should be understood as needs, how can we separate the legitimate needs, and whose job is it to do so?
The basic principle in most public health care systems is that the services should be distributed according to the patient’s needs. This implies that the services first and foremost are supplied to “those who need it the most”. But the problem arises when someone has to decide which needs are more important than others. Even though doctors and medical personnel have the best prerequisits to decide on the matter, it may be unreasonable to demand that they take all the responsibility. If something goes wrong, they will be the first to be blamed. Is the system in itself not responsible for a fair distribution of medical care and treatments?
Norway implemented a system of primary doctors for each citizen in 2001, and since then the consumption of medical services has increased more than previously. The capacity is not large enough, and so the waiting periods for certain treatments and care facilities are too long. In order to do something about this excess demand, we have to evaluate social norms and really assess our need for health care. Needs are mostly created by society, and demand is thus composed of both subjective, social and objective components. If society created the needs, can’t society also take responsibility and decrease the demand to a sustainable level? It is a difficult challenge to deal with, and in all fairness, every branch of society should participate in order to fight this increasing demand issue.
Lene Hole Didriksen