It is striking how much people around the world have in common when it comes to healthcare delivery. They share, for example, a perception that their governments should be doing more to make healthcare accessible to the most vulnerable and that their governments do not engage them enough when it comes to setting priorities for healthcare spending.
We learned this in the Accenture Citizen Experience Study (ACES), a 16-nation study we unveiled recently to examine people's views about the quality of healthcare and government's role in improving it. We surveyed more than 16,000 people in Australia, Brazil, Canada, France, Germany, Hong Kong, India, Ireland, Italy, Japan, Mexico, Norway, Singapore, Spain, the United Kingdom, and the United States.
We asked people questions on two dimensions – to rate the importance of specific actions related to their healthcare services and how well their government is delivering on those actions. While there is great variation not only in health systems, but also in the social, cultural and economic factors that determine people's expectations of government, the survey revealed a strong consensus among the participants about what they want from their health systems:
- Fair, easy access to healthcare for all is a concern for a majority of people, regardless of where they live;
- Citizens want their governments to intervene and help mediate when they have problems or difficulties with their healthcare;
- Citizens feel disengaged from the decision-making process related to health care;
- People perceive large gaps between actions they value in healthcare and how well their respective governments work to ensure those actions happen.
These gaps are perhaps the most telling – and provide the best indication of where governments should concentrate their efforts. On average, 75 percent of respondents worldwide rate government help in resolving problems or difficulties in receiving health care as an essential or very important responsibility. Yet only 26 percent think their government is performing this well - a gap of almost 50 percent.
There are important differences among countries on more specific priorities. For instance, it comes as no surprise that in the United States, the cost of healthcare is a top concern, while citizens in many other countries list quality of care as their top issue.
People also draw a distinction between the impact of government policies on general health issues and individual health issues. Only two countries – Brazil and Ireland – prioritized the need for government to ensure that health services deliver real improvements in the health of the nation as a whole.
Among the remaining locales, 70 percent rated this essential or very important, but not as important as other government actions. I take this to mean that while people value improved public health outcomes, they take a back seat to people having access to health services for themselves and their families and that everyone has the same opportunity to access quality health services when they're needed.
It is easy to imagine how frustrated people are with their healthcare systems when they feel they have no voice in setting spending priorities or enlisting their government's help in solving problems. Conversely, imagine what societies could gain if governments actively solicited their citizens' views on what works and what doesn't.
Our research represents a snapshot of citizen input and the message we heard is loud and clear – citizens want to be co-producers of public value to improve healthcare in their countries. Governments would be wise to take heed.
-- Steve Rohleder is chief executive of Accenture's Health & Public Service Operating Group
