16.00 – 18.00 Section 3 
Section partner - MEDTRONIC

2020 - The future of Healthcare in Europe
Imre Boncz
(University of Pécs, Hungary)

 Presentation (password needed)

Imre Boncz is a director of the Institute for Health Insurance at the University of Pécs, he is also a vice-dean at Faculty of Health Sciences at the University of Pécs
and a secretary of National Advisory Board for Health Care habilitation (Dr. Habil), University of Pécs. Former Director for strategic affairs (Coordinative Center for
Medical and Health Sciences). He is the graduate at the University Medical School of Pécs (M.D.) Post-graduate trainings and studies at the University of Sheffield,
Vienna School of Clinical Research, Erasmus University Rotterdam.

Europe can be divided into several special groups of countries, which are facing similar problems in the healthcare sector – Healthy & advanced (Northwestern Europe), healthy & middle class (Southwestern Europe) and unhealthy & emerging (Central and Eastern Europe). These countries face major challenges in healthcare related to the health status (demography, epidemiology, life expectancy) and economy (GDP, health expenditures).
The future trends in healthcare will be influenced by the technological development and the population structure. These will have a great impact on the increase of public health expenditures. Cost cutting will be possible on three levels:
1. Macro level: budget caps, supply constraints, price controls
2. Micro level: public management and coordination, contracting, market mechanism
3. Demand side: patient cost-sharing, private health insurance

Strategic scenarios 2020: The future of CEE healthcare
Peter Pažitný
(Executive director of HPI,member of CEE HPN , Slovakia)
 Presentation (password needed)

Since January 2005, Peter is the founding partner and the executive director of Health Policy Institute – a Bratislava based independent think-tank which analyzes health policy in the Central European countries. He is the graduate of the University of Economics in Bratislava (1999) and he helds a postgraduate MSc. Degree in health management services from the Semmelweis University in Budapest (2003). During 2002 – 2004, Peter was the chief advisor of Minister of Health Rudolf Zajac. He was fully responsible for the expert part of the health reform, for daily management of the Reform Team and for operative tasks linked to the ministry. In 2006-2007 he was member of Advisory Committee to Ján Gajdoš, Chairman of Healthcare Surveillance Authority in Slovakia. During 2006 – 2007, Peter was advisor to Lajos Molnár, Minister of Health in Hungary. Between 2007 – 2009, Peter was advisor to Tomáš Julínek, Minister of Health in Czech Republic.He is also the founding partner and CEO of the Health Management Academy. He teaches health care financing and health policy. Together with Rudolf Zajac, Peter is the co-author of a publication „Healthcare Reform Strategy – a Real Reform for the Citizen (2001)” that served as main source for the health care reform implemented in Slovakia in 2004. He is also the co-author of „Health Systems in Transition: Slovakia, 2011“ a prestigious publication published by the European Observatory on Health Systems and Policies.

The future is open and cannot be predicted. The goal of strategic scenario planning is to abandon our initial ideas about the future and realize that the world of tomorrow may not correspond with our today’s ideas about it. Strategic scenarios will remove the blinds from our eyes, will help us overcome our blindness and get rid of our tunnel vision of the future.
They will enable us to “think about the unthinkable”. They will enable us to think over and above of our usual - individual, group, organizational or national - frame (“thinking outside the box“). They will enable us to realize that the future can bring us great opportunities and great threats that we have never thought about and, therefore, did not prepare for. Strategic scenario planning “gives us new eyes”. We will never see the future the way we used to see it before.

Consumer rules
This scenario describes events that led to a radical departure from conventional wisdoms about the medical profession, society, and healthcare provision. Driven by young patient advocacy groups and engaged citizens using up-to-date information technology a series of political, social, and economic changes ensued. There is a well-functioning competitive health insurance market with a large number of different health insurance products (health plans). Health plans can differ and compete with price, structure of the healthcare providers’ network, different levels of applied managed care tools and the quality of administration as well.

Government serves
In this scenario, the government refused to appease with the doctors again, announced a sound fiscal policy and hired a young group of technocrats to prepare a strategic plan. This scenario describes a system, where the main health policy tools are regulations and the attempt to handle the side effects of overregulation. The government objective for maximizing benefits for the whole society resulted in overregulation and created lots of reporting duties and unnecessary bureaucracy. Each change had to be tuned with new regulations. Major Superbodies played the decisive role in the system.

Industry drives
No power group – neither doctors, nor consumers or social engineers – no matter how straightforward it appeared at the beginning, could resist the interests of profit-seeking industry for long. The capture of the stakeholders was sophisticated, slow, but perpetual and somehow inevitable. This is the story when industry drives. Industry took the lead and the focus of doctors and providers was on the procedures and not the patients. There was no demand for information; there was a demand for recommendation. Access brokers started to play an important role. Government was hiding behind the saying “the system is liberal, market players are responsible”, while it was being deregulated and liberalized without a concept.

Doctors dictate
In this scenario only doctors ruled the system. The president of the Medical Chamber became the Minister of Health and every new law had to be discussed first with the Chamber of doctors while only after its approval, the law was released for further comments. The managers of hospitals were solely doctors, who had to be approved by the newly established ministerial advisory board constituted only from doctors. The power of doctors was further increased, because doctors acted also as staff at the Ministry of Health, heads of university hospitals, CEOs of insurance companies, health policy makers, academic staff at universities, and even as journalists reporting on medical affairs. An independent journalist, who was fired from a Medical Weekly characterized this situation as “white clan”.

Panel discussion
Leoš Heger
(Minister of Health, Czech Republic)

In view of the catastrophic situation in the Czech Republic caused by ethanol case, Mr. Heger did not attend the summit.

Panel discussion 
Miklós Szócska 
(Minister of Health, Hungary)

Dr. Miklós Szócska is Minister of State for Health at the Ministry of National Resources of the Republic of Hungary since June 2010.Dr. Miklós Szócska graduated at Semmelweis University of Medicine in 1989.  His interest in the management of health services organisations emerged in the late ‘80s when he was a student president elected from the opposition.
After graduation, he and his colleagues initiated the creation of the Health Services Management Training Centre.  Since then Dr. Szócska has leading responsibilities in the development of the Centre as an institution and the development and implementation of its training programmes.
Between 1995, the official creation of the Centre and June 2000, he was responsible for the every day operations as deputy director.  In June 2000 he has been appointed as acting director of the Centre, of which he became the director in October 2009. Next year, in 2010 he has been appointed as dean of the Faculty of Health and Public Administration of the Semmelweis University in Budapest. He also had critical role in establishing the Centre’s international relationships and recognition. At present, the Centre also serves as the Partner Institute of the World Bank Institute for its Flagship programme on health reform and sustainable financing. He serves on the boards of the European Health Management Association and the European Health Property Network.
The Centre is the Hungarian representative in the European Health Property Network, the organisation that aims the renewal of European health infrastructure investment strategy.
His research activities cover various domains of health management and policy. His recent research projects address the critical aspects of management of change, migration of health professionals and the implications of social network studies on the organisation of health care systems.
He holds a Master of Public Administration degree from John F. Kennedy School of Government at Harvard University, and a Ph.D. from the Semmelweis University in the field of change management.Among other public service duties, Dr. Miklós Szócska was member of the Supervisory Board of the National Health Insurance Fund in 1992-1993, elected by National Parliament.
Not available.

Strategic Scenarios 2020 – Film N°4: Unity

18.00 – 19.00 VIP coctail

20.00 – 22.00 Gala evening & dinner with a unique interactive performance of Strategic scenarios 2020
Special partner – Dr. MAX


© 2020 Central & East European Health Policy Network
CEE HPN brochure