According to McKinsey, Estonia's GDP could increase by a tenth if premature mortality decreased and people stayed in the labor market longer. Good health also increases work capacity and productivity - one euro invested in health yields 2.4 euros in return.
The impact of the healthcare system on public health is surprisingly small. Determinantsofhealth.org points out that the medical system accounts for 11 percent of the final health outcome, while health behavior and lifestyle account for as much as 36 percent. Our future is bright if health behaviors improves across the entire population, which would mean that people need to become active participants in their own health decisions and outcomes. Unfortunately, this does not happen by itself; it requires vision at national level, creating both motivation and opportunities.
Today's Healthcare System Soon Needs a Life Support Equipment
Chronic underfunding of Estonia's healthcare system is no news to anyone, as long-term trends are materializing - an aging population, increasing burden of lifestyle diseases, decreasing tax revenues and more importantly, a decreasing number of doctors, with 1 out of 2 general practitioners and mental health specialists being of retirement age. In other words, costs are growing faster than revenues. Additionally, we are witnessing long waiting lists for specialist care, and problems at other levels of care are piling up in nursing care and emergency medicine. People cannot access doctors and treatment often starts later than it should, causing greater harm to health and putting further strain on a healthcare system already suffering from staff shortages and increasing healthcare costs.
There is also a growing staff shortage in the field of mental health. Over half of psychiatrists are of retirement age or will reach retirement age soon. According to the National Institute for Health Development, Estonia has about 15 psychiatrists per 100,000 people, which is significantly less than in the Nordic countries. For comparison, the number of psychiatrists per 100,000 people is 26 in Norway, 24 in Finland, 23 in Sweden, 23 in Lithuania, and 16 in Latvia.
Healthcare costs per capita have risen sharply since 2003 when it was 327 euros per person. In 2022, the costs were nearly two thousand euros per person.
Maintaining Current Service Levels means that Health Insurance Fund Costs Will Grow 24% Faster Than Revenues by 2035.
The Centre for Development Monitoring said in its analysis in 2020 that if no fundamental changes are made to the system, by 2035 people's premiums and co-payments could double, waiting times for treatment could lengthen further, and the health insurance budget could reach a deficit of €900 million.
Low health awareness and lack of responsibility for one's own health lead us to an early grave.
We also give minimal attention, far below what is necessary, to the broader field of healthcare, for example, raising health awareness and secondly, prevention, not only in terms of activities directly related to disease, such as screening and genetic testing, but also in terms of health awareness and education, and a healthy environment.
We are accustomed to relying on the medical system, doctors, and medicines to cure us in case of trouble. Few are used to thinking that our health depends primarily on ourselves; my mental and physical well-being is primarily my own responsibility, and only then can I seek help and demand treatment from the medical system if necessary. As time goes on, personal responsibility becomes more critical, as today's availability of medical care is a luxury that will become increasingly scarce without fundamental changes.
According to recent studies, 50% of all deaths are directly related to health behavior such as diseases resulting from unhealthy lifestyles (alcohol, tobacco, high sugar, lack of exercise) and obesity-related cardiovascular diseases, chronic lung diseases, some types of cancer or diabetes. These are diseases whose causes are largely rooted in our lazy and over-consuming modern lifestyle, including high alcohol consumption, where Estonia still ranks in the top ten in the world.
In financial terms, we lose 1.5 billion euros every year in Estonia to lifestyle diseases and premature deaths. In addition to direct treatment costs, lifestyle diseases cause significant non-health-related costs, such as reduced productivity and informal care costs due to mortality and morbidity. For example, in 2015, the reduction in productivity due to lifestyle diseases was estimated at 54 billion euros in the European Union. At the same time, control and prevention of these diseases are highly productive - the American health organization has calculated that every dollar invested in preventing lifestyle diseases will bring back nearly seven dollars by 2030. It's hard to find newer calculations for Estonia, but since the prevalence of lifestyle diseases is on the same scale worldwide, the idea remains the same.