During the 2008 campaign President-elect Obama identified Healthcare as a priority based on a stark analysis – 47 million Americans without healthcare insurance (a jump of over 22% under the current administration), high levels of waste and inefficiency (25% of spending swallowed by administrative costs) and poor health outcomes relative to other nations. 

So it is not surprising that affordable healthcare is a priority issue for the incoming administration. 

But what is interesting is that an affordable healthcare policy was positioned by President-elect Obama within his agenda for economic revival – and is understandably recognised by most Americans as a domestic issue that needs fixing and, given worsening economic circumstances, needs fixing  fast. 

In matters of policy development, structure is significant.  Responsibility for policy development and delivery must be clearly allocated, expectations must be managed, performance must be measurable.  Structure sets the scene for accountability – and departmental boundaries. 

In the incoming administration, however, we see a chance for a more collaborative, less rigid, less dogmatic approach to policy development – less demarcation, more cross-cutting (and cost-cutting) cooperation – without any lessening of ‘buck stops here’ accountability.

So it is timely to question the healthcare contribution of other agendas. 

The campaign theme ‘Investing in our Prosperity’ is all about creating the nation’s economic future.  The agenda includes Education, Science and Technology as well as the headline-grabbing policy swings on environmental issues.   We should ask to what extent are those charged with developing these policy areas cognizant of the delivery priorities for healthcare ? 

Another great campaign theme – ‘Rebuilding America’s Leadership’ – recognized many health-related policy areas for foreign policy, including acknowledgement of global issues where American leadership can make a significant difference.   President-elect Obama is deeply aware of the need to rebuild the image and appreciation of America amongst the citizens of its allies. A useful question to ask is whether America, in developing this outward-looking leadership agenda, can also recognize that for healthcare policy it has much to learn from other nations and regions.   

To spend more per capita on health than any other nation and yet languish in the global league tables for life-expectancy (29^th) and infant mortality (38^th) would suggest that deeper involvement in healthcare systems and technology development in, for example, Europe, would contribute towards the evolution of America’s domestic healthcare policy and, at the same time, support foreign policy objectives. 

In the same way that it would be short-sighted to so rigidly draw domestic policy boundaries, it would be less than imaginative if notions of self-sufficiency and independence railed against the reciprocal encouragement of knowledge transfer and the astute use of overseas locations for some technology developments.   Mechanisms should be found to foster greater global collaboration and mutual support without these falling foul of patriotic calls to stand alone. 

In healthcare one of the areas that will, during the next two Presidential terms, have the greatest impact on healthcare affordability is the fast-growing field of ‘Connected Health’.   This is far more than clever gadgets and better broadband networks to enable personal health monitoring.  It is a healthcare revolution that transforms the use of expensive hospital facilities – and a revolution also in personal attitudes to health. 

In tackling obesity, for example, who would have imagined that in 2008 a Japanese computer games manufacturer would, in effect, sell millions of bathroom scales as an essential accessory to its keep-fit games ?  Who would have imagined that the formerly troubled corner of Europe, Northern Ireland, is now taking the lead for driving forward Connected Health in Europe?    

The interdependencies between the agendas for Health and Wealth (and better broadband) are well understood – particularly in countries like Northern Ireland where the pre-recessionary need to face up to economic and social challenges have, instructively, provided a platform for growth that merits both American enterprise investment seeking a stepping stone into European markets and further study by policy developers seeking an infusion of fresh thinking.

Healthcare, and particularly ‘Connected Health’, is clearly an essential ingredient of the nation’s domestic policy agenda.  It should also be recognised as a significant and high value strand of America’s foreign policy and future prosperity.

________________________

Notes for editors 

The author is a director of the European Connected Health Campus, a Community Interest Company based in Belfast.

Statistical references in this editorial have been sourced from 'Change We Can Believe In' - (c) 2008 Barack Obama and 'Obama for America' ISBN 978 84767 432 6

This editorial is (c) 2008, ABFL Groupe Intellex.