In 2012 eleven percent of the global population (over 809 million people) was over the age of 60. By 2050, that figure is projected to rise to 22 percent, or over 2 billion individuals. While healthier and longer life spans are amiable advancements, one of the major implications of an aging population is the destabilization of the welfare systems of most nations. With larger percentages of the population dependent on welfare and fewer citizens contributing to social service budgets, it becomes increasingly difficult to obtain the funds necessary to support the dependent population. Aging populations and increased life expectancies require more effective and efficient health care systems.
Currently, only 32 countries in the world maintain universal health care systems which provide greater equity in access to health care services and protect citizens against taking financial risks to obtain health services. In countries that lack a universal health care system, the most important indicator of life expectancy is wealth, which determines access to medical insurance or the ability to pay for treatments directly. A European study published in 2015 found that patients of diverse socioeconomic backgrounds experienced the same amount of medical need but sought out varying levels of treatment based on their economic status. In order to adequately care for aging individuals of all income levels, it is important to have a health care system that is able to effectively meet the needs of all citizens and does not discriminate against people based on their socioeconomic status.
Beyond providing the necessary health services to care for the overall physical health of the elderly, it is imperative that health care policies address the negative effects of ageism. The World Health Organization (WHO) defines ageism as “the stereotyping and discrimination against individuals or groups based on age”. Ageism can be expressed through prejudicial attitudes, discriminatory practices, and institutional policies that perpetuate stereotypical beliefs. Additionally, WHO estimates that nearly 16 percent of elders are subjected to elder abuse which manifests through physical, sexual, and emotional means. In order to ensure the health and well-being of an aging population, it is vital to establish health care systems that cover individuals of all socioeconomic strata and provide an age-friendly environment.
II. Country Policy
As of 2013, Portugal had a total population of 10,350,000 with nearly 25 percent of the population over the age of 60. In 1979, Portugal created legislation that introduced and established the right of all citizens to health care through the National Health Service, which guarantees universal healthcare for all citizens regardless of economic and social background. Ninety percent of the National Health Service is financed through taxes with the remaining ten percent financed through co-payments and direct payments from patients. With an aging population that requires more medication and health services, the cost of the universal health care continues to increase and currently amounts to just over 10 percent of the country’s GDP. In order to increase the efficiency of the National Health Service, Portugal created the Portuguese National Health Plan in 2012 which established a set of guiding principles and strategies for individuals and institutions to contribute to improvements in health outcomes in Portugal. The Portuguese National Health Plan aims to integrate the services of the National Health System by promoting intersectional and multidisciplinary communication within and between medical institutions. It also attempts to expand intersectional research programs and provide more comprehensive care to patients. Integrated health care systems work to treat the patients as a whole, and communication between physicians usually results in simplified treatment plans which are easier for patients to follow. Additionally, increased communication between researchers promotes a collaborative environment of collective data sharing which helps new medical technologies come into existence.
Internationally, Portugal is a member of the Community of Portuguese Language Speaking Countries (CPLP) and signed onto the Strategic Plan in Health Cooperation for the CPLP which aims to improve training for doctors while increasing specialized training, strengthening scientific research in public health, and increasing collaboration in research among members of the CPLP. As a member of the European Union (EU), Portugal supports the EU Health Policy Platform which provides a framework to increase dialogue about research and treatment plans both in-person and online between members. In September 2014, Portugal signed the Country Cooperation Strategy (CCS) with the WHO, creating alignment between the Portuguese health care system and WHO leadership priorities. Through this partnership, WHO provides feedback on the Portuguese health care system while Portugal shares with WHO what aspects of their health care system have been most efficient. As a member of WHO, Portugal has also agreed to the Global Strategy and Action Plan on Aging and Health with the goal of maintaining functional ability and wellbeing in old age. WHO aims to achieve this goal by developing affordable integrated health care for elderly, fostering older people’s autonomy, and enabling their engagement in society.
III. Country Solution
As an extension of previous policy established in the Strategic Plan in Health Cooperation for the CPLP, the nation of Portugal would like to focus their attention on creating an environment that promotes collaboration in medical research. By partnering with other research laboratories, researchers will have access to more data that will allow them to find more effective treatments and even cures for noncommunicable diseases sooner than they would if they were to work alone. Additionally, by sharing data with other researchers, all members involved will have greater access to resources and experimental results that will assist them in furthering their research. According to WHO, noncommunicable diseases are responsible for nearly 70 percent of global deaths annually. Improving treatments and developing cures for noncommunicable diseases will help improve the quality of life for elders and other members of the population who suffer from these diseases, and will have a much broader overall impact. In order to achieve this goal, member nations of WHO should work to create a digital platform to connect researchers to other institutions in the same field of study.
Furthermore, in line with the Portuguese National Health Plan, Portugal would support the development and implementation of intersectional treatment plans within hospitals. Increasing communication between hospital departments will allow physicians to coordinate treatments for individual patients resulting in a more effective treatment plan that is easier for the patient to follow. Intersectional treatment plans will enable physicians to treat the patient as a whole and provide a greater quality of care, improving the patients quality of life. The first step toward this reality would be to create digitized and secure health records that contain all of a patient’s medical history and are able to be shared within and between hospitals to all physicians who treat the patient.