From Europe's strained public systems to the complexity of US medical services, the cost of care continues to rise.
With people living longer and quality of service often declining, what will it take to break the ongoing cycle of rising costs?
Simultaneous interpretation in English and German
At Davos, leaders from government, industry and academia reframed a familiar budget fight: healthcare is simultaneously a cost, an investment and, for some, an “end point.” Germany’s Health Minister Nina Warken argued there is “keine Entweder Oder,” calling health spending an investment not only in healthy years and reduced long-term care, but also in institutional trust: “If we lose their trust… they’re going to turn towards radical powers,” making health an investment in democracy. Economist Stefanie Stantcheva emphasized why pure market solutions fail in health due to externalities, moral hazard, adverse selection and redistribution needs—problems compounded by collapsing trust in science since Covid. India’s Suneeta Reddy linked private capital to national capability, citing reduced medical tourism and talent retention, while warning that “healthcare becomes a cost if you ignore prevention.” AstraZeneca chair Michel Demaré urged governments to treat health as a “strategic asset,” noting Europe’s underinvestment and arguing that investing in the 15% of budgets spent on medicines can unlock savings in the other 85%. Siemens Healthineers CEO Bernd Montag contended non-communicable diseases require “personalization at scale,” enabled by early detection, digital records and AI to avoid multiplying labor costs. Across perspectives, the throughline was pragmatic partnership: prevention, digital infrastructure, outcome-based financing and public-private innovation to bend the cost curve without eroding access.
Good afternoon. Welcome. You are in a session where we are going to look and answer the question of healthcare. Is it a cost or is it an investment? Welcome. I want to start by congratulating the World Economic Forum for bringing this question back and putting a focus on it. It goes back to the days I remember in 1984 when I visited World Health Organization, met with Halfdan Mahler, talking about health for all. And the question of cost was sort of mixed in there somewhere. But it was really in 1993, in the World Development Report, which was authored by Chris Murray and Alan Lopez, where they made the case very clearly that health and good health was essential for productive people, and that contributed to accelerated development. But this question is healthcare. A cost to an investment is common in the corridors of the Ministry of Finance, because they want to know what's the return on that investment. And so today we have with us an illustrious panel that's going to address that very question. We have with US Minister Nina Walker from the Minister of Health from Germany. We have Stefanie Stantcheva from Harvard University, where she's professor of political economy. We have Sunita Reddy, who is the managing director of Apollo Hospitals. We have Bente Montague, who is the CEO of Siemens Healthineers, and we have with us Michel Desmarais, who is the chair of the board of AstraZeneca. So we have a very illustrious panel. So I'm going to plunge into the questions, and we're going to go through three rounds in the course of today and this afternoon. So let's start with Minister Wharton. Tell us from your perspective, is healthcare a cost or an investment?
Ich glaube, dass das nicht getrennt von ist es gibt keine Entweder Oder natürlich Gesundheit kostet ein gutes Gesundheit kostet. Aber es gibt keine alternative aus meiner Sicht. Es ist immer auch ein investment in die.
It's an investment into the health of our citizens. We want to ensure that they have many healthy years. We want them to be able to work and also avoid long term care needs at older age, as long as possible. And that's why it's important for a country to have a healthcare system and to finance the system as well, in which our citizens can trust. Because if we lose their trust into the state, into the functioning of the institutions of the healthcare system, then they're going to turn towards radical powers. So it's also an investment or investments into the health sector are also an investment to into our democracy. So there's no either or to it. We have to spend the money. We have to make sure we use it more efficiently. That's certainly true. We have to balance out expenses and what we take in, but we have to spend money and that's okay. Thank you.
Thank you very much, Minister.
So, Stefanie, tell us your thoughts. Are we talking about a cost or are we talking about an investment?
It's a great question. And let me give you the economist's perspective here, which is it's definitely both, but it's very special kinds of costs and investments. It's not like the costs and investments a private business would take into account, because there is something we call market failures as economists, which are prevalent in the healthcare system. So what are market failures? Well, it's when markets cannot work because there's these frictions. There's these things that prevent them from working. And if I say there are so in healthcare, you know, we economists love markets. So if we say they're market failures it is serious. So what's happening in health is that first of all, there's a lot of externalities. That means the actions of one person affect others. You know, if I smoke, I'm not just destroying my health, I'm also affecting all of you around breathing smoke. If I don't get vaccinated, it's not just me who's going to get sick. I can also spread it to others if I don't do preventive care. And so this externality is something that the private market usually has a lot of problem dealing with. Another thing is what's called moral hazard. We don't control people's actions. So when a patient complies or doesn't comply, if they take more health risks or not, there's also adverse selection, which means, we don't know people's health risk. They know much more about themselves. And so insurers have a problem, you know, if it's left to the private market, only the highest risk people want to pay a given price, making insurers want to raise the price even more and causing what might be a death spiral, the whole market unraveling. So that's why private health insurance often has these issues. In addition, there's also the aspect of redistribution. You know, private markets often cannot handle, you know, paying for low income families, health insurance or health care. That is, you know, again, something that as a society, we might want. So all of these actually make it an area where these costs and investments are very special. So there's a real scope for the government to, to intervene. So it is not something that can just be handled by the private market. And I think to me that takes us to what I want to talk about later, which is the big role of public policies for this.
Well, thank you very much, Sunita.
Thank you. So I'm Sunita Reddy, and, as a daughter of a founder, I was probably the first one, maybe 35 years ago, who raised money, private FDI into health care. And even then, it was difficult for me to explain that health care is an investment. So it's wonderful to be here on this stage, to be able to accelerate, to emphasize this fact, because the returns that we see, can be measured. 80% of the Indians used to go abroad for treatment before the starting of the private sector and investments into health care. Not only that, we were losing doctors. So I think skills are very vital for the growth of the economy. And India was, as we've lost we've already lost doctors, engineers, but now we have the ability to retain them in our country and bring them back. So there's now a very vibrant health care system. And for it to grow in India needs it very badly. We need, you know, we have one bed for every 100,000 we need for. So we do need investments into health care. And the reason why I call it an investment, because not only is there a return in terms of health outcomes, but there's a return in terms of investments. And this happens because we have the volumes. We're able to deliver clinical outcomes at scale. And I think all of this coming together with a, you know, a structural demand for healthcare makes it a very important value proposition, makes investment into health care. And I think, for the past 20 years, all those who have invested into healthcare in India would agree with me. And I'm sure that we're here to support the government because we're there to make the infrastructure, build out the infrastructure for the government.
Wonderful. Thank you very much, Ben. Tell us from your perspective of Siemens and technology.
So I want to be difficult. Okay. Please do. And that means I don't know whether I agree to the question. If one can agree to a question at all. But there is there is a bit of a, you know, there's always a statement in a question. Yeah, yeah. And that, that these economic terms of, of cost and investment, that they are the right way of looking at it because in one sentence you brought was, you know, is it a cost or investment in order? You know, we need to keep people healthy so that they are productive. I can turn it around. I mean, maybe we have the economy and we are productive so that we can be healthy and can afford to be healthy. So, so from that point of view, I find, yeah, the question is more like, you know, you spend the weekend with your family, is it a cost or an investment or is it an end point. Yeah. And I think this makes a bit of a difference. Because I think it's a on the one hand, a necessity. It's not an option. Yeah. In German alternative. Yeah. Or it is, it is always right to prioritize it. Yeah. Also, you know, for what makes up a nation and what makes life worth living and what makes it worthwhile to live in a, in a certain nation. And I think to to remember that it's an end point and not a means to an end, I think is important. And I hope this is not a too esoteric view from somebody who is currently CEO of a company. Yeah.
But I love it. You know, let's turn the world upside down. And I like the way in which you you took the essential concept and you've given us a different perspective, looking at it as something that we want to aspire to getting good health and that the economy feeds that rather than the other way around. Thank you. Michelle. Your thoughts?
I do agree with your question.
To start with a starting point.
And obviously in my perspective, health should be an investment. And if you look at it, we have not seen more exciting times in terms of medical science. For the moment, when you see all the new technologies, the new modalities that are coming up that are have really the potential to transform diseases that were considered fatal will soon be manageable or even curable. So there's a huge opportunity there. But also it comes at a high cost. And that's why the only way to solve that is to consider health as a strategic asset. And a strategic asset obviously requires investment. The good part with investment is that when you talk about investment, you can talk about return on investment. And in fact, there's many different ways to measure that. I would start with the most important is the health of the population. If you invest, you get the population in better health. Let's for instance, take the example of investing in prevention and early action. If you are doing that, people get treated earlier. Over time, you will have less hospitalization, you will have less late treatments that are very expensive and often too late. So you can really turn around a little bit. The whole budget balance of your health system and the better health of population also means higher productivity, less sick days. You invest, you create jobs, you create growth. So from that perspective, I think it's quite easy to measure a third one that has become extremely important in the last years, unfortunately, is, your health sovereignty. In a way, if you look, take Europe now, you know, we have all committed to increase our spending on defense, but does it make sense to spend 5% on defense to be autonomous from a military point of view, but depend on other countries for health innovation and to treat your patients? That obviously is a question to be asked. And the last one, I think if you if you go into a mindset of investment, you also create a sandbox where private partners can invest. Nobody is interested to invest in filling a hole in a budget. You want to invest for the long term. And so I think with that, we could really turn around the whole philosophy of how to manage a health system. And we need to do it. You know, for the first time in the last 20 years, the public spending on health in OECD countries has declined, which is crazy to think. If you see the number of diseases and chronic diseases that are in the world. So that's the result of budgetary constraints, cost containment. And obviously it's something we should try to turn around.
Absolutely. As we think about healthcare and we think about the way in which the costs are being driven, being driven by new technology, being driven by inefficiencies in health system, by the cost of health care personnel, the cost of drugs. But also, if we look at it the way you're talking about as an asset, we have a different perspective to think about and bring in players who are looking for returns on that investment. So let's let's go around. I want to pick up on some of the points you made. And let's start with you, Minister. I think, you know, you referred to about resilience and sustainability and in particular in your experiences in Germany. Just share with us, you know what? What would that look like and how can we achieve it, say in Germany where you are dealing with it, you know, on the ground? Share with us your perspective.
I think healthcare system that is sustainable and resilient has to provide healthcare for its citizens, regardless of the level of income and whether you live in a city or in rural areas. And it should be, regardless of whether you are at peaceful times or crisis times. Sustainable healthcare system has to balance expenses and contributions, and this is something that poses a great challenge for us. We have to see how we can balance out and stabilize the contributions. So we have to balance out expenses and contributions better. For this, we need savings because increasing contributions are not good for our citizens, but also are detrimental to companies. So it's also an economic factor that we're talking about here. So we have to get better in this regard when it comes to the quality. Also throughout the whole of Germany, which is why we currently undertaking a hospital reform in which we're trying to establish more specialization and and ensure a good basic primary provision throughout Germany, but have then units that specialize on certain operations or certain treatments. This is what we're working on at the moment, and we're also reforming our emergency care. We also try to make sure that patients are channeled more effectively through the whole system. Looking at the patient doctor contacts and want to make sure that if they really need an appointment, that they don't have to wait a long time. So reduce waiting times. We want to become more efficient. So we have a primary care system where we want to have a primary doctor that patients go to. And this doctor, this physician then tells you where to go to and within what time frame. And we want to try and control the system better so that we can provide more targeted care for our patients. And looking at skilled workers, there's a lack of that as well. Of course, I want to also make sure that we use these, this scarce resource more efficiently. So these are the the big tasks that we're tackling at the moment. The hospitals and physicians have also been made fit for new challenges. So we are also investing into cybersecurity in hospitals and also doctors practices, laboratories, medical institutions in general to make sure we're equipped for the future. We initiate transformation processes. We work on more digitalization. And another part of resilience is that we also prepare for further crises, whether it's, making sure we have access to pharmaceuticals, creating incentives in the European region for production sites in Europe for supporting our pharmaceutical companies, the Maytag industry, to try and make sure that they can ensure the supply with what we need for our own citizens. And we are also preparing a an act that in case of war, our citizens and also the wounded can be treated adequately. So it's quite, a broad and sophisticated package of measures to try and be prepared for good care of our citizens wherever they live and whatever their income level.
Thank you very much, Minister. I was particularly intrigued about the way in which you were talking about ensuring that you improve efficiencies by ensuring you streamline the way patients go through the different levels, so you're not consuming large amounts of resources by jumping levels, but rather filtering through the system. It'll be interesting in the next, round when I come back to you, if you've got any thoughts about how innovations might help in in ensuring that because that's one of the ways in which we can improve the efficiencies. So let's go to Michelle. Your thoughts on, you know, just you've highlighted, you know, the whole issue about the investment and you've talked about there being an underinvestment. How can governments, you know, that face a lot of competing priorities and pressures. How do you see their roles in this investment game? We just heard from the minister very eloquently the challenges she's facing. Your thoughts, Michelle.
And actually, I had a meeting with Minister Farrakhan before. So we we already had the opportunity to discuss that. And obviously it was mainly focusing on Europe, because in Europe we really have an issue that is becoming more and more serious because the level of underinvestment. You have to realize that if you look at the global share of R&D spending, Europe has lost 25% of shares in the last 20 years. As a result, there's less and less investment. Now there's 40% of the new medicine invented globally. Do not come to Europe because of that. So we need to change. And I'm actually very encouraged by the open minded attitude of Germany. I think they are really showing the way for the moment in Europe to engage as a farmer dialogue that the minister has put together, where all the actors have an opportunity to contribute and try to find solutions. My view is that the first ask is already a difficult one. We need to start having a longer term vision and it's always obviously the problem. You talk to a minister, to a government that is elected for four years and you are talking about returns for five, seven, ten years. It's always very difficult to get into this, but it's the only way to start looking at it from an investment point of view. I think as well, we need to think much more holistically, holistically about the health system at the end. There's so much focus on medicines that, for instance, in Europe, representing 15% of the total budget of a health system, it would be much more useful to see if we invest in this 15%, how much savings can we generate from this 85%? The leverage is really huge. Then there's obviously a whole regulatory aspect that needs to be addressed faster authorization, better IP protection. And then finally, is the whole sustainable financing part, you know, how do we price. And again, I think Germany is leading that way where pricing is driven by outcome, not by fitting into a budget. Same for instance for cost containment measure that I think are very unfair for the industry. So Clawbacks, for instance, basically, we are taking over the budget risk without being able to manage it. So these are a few solutions that we could work on and that we are engaging. And I'm very encouraged by the meeting we had today. I think we are on the right path to start having a productive dialogue.
And thank you for just just highlighting that. One of our big challenges is that we often forget about the investments that we can make in primary care and prevention for their long term benefits, because we are so stuck in, you know, the patient that's sick and in the room right now, we're forgetting about all that it takes and that investment that.
You know, health system on average in the OECD spent 3% of their budget on prevention. You triple that. You will have a very big return on investment.
Absolutely. We've got to do better. So tell me from from your perspective, you know, you're running a hospital system. You heard how ministers talking about some of these challenges and you've been innovating and making that investment and looking at that return on investment. Share with us your thoughts. You know, what are some of the strategic things that you are facing.
In terms of cost? You know, India is already at one tenth of international cost. And I think that innovating in terms of bringing down the cost further would be a challenge. What we really need to do is to look at the appropriate healthcare for the appropriate patient, what does the patient need? And for that, I would triangulate three things. First, who is the payer? Who is paying for the healthcare in India? A lot of it is retail. People come, they pay, but now insurance is picking up. So I think we have to deal very well with the insurance providers and make sure that, you know, the policies, people have access to insurance. So I would encourage the government to really they have now 100% FDI into health insurance. So I think, you know, triangulate, payer, triangulate clinical outcomes. The third, the networks of care. So for primary care, you don't need to go to a big hospital. So create networks which are primary, secondary, tertiary community health care that works for the community and not just for the person and connect it all with the digital system, which is what we are doing now. We have about 7000 pharmacies, 2000 touch points for diagnostics, but connecting it through to a digital system is is very crucial for the whole network to work. I want to add here to the point made by Mr. de Maron on preventive healthcare. You know, 14% of the health care spend is on preventive, and that is very low. I believe that healthcare becomes a cost if you ignore prevention. And it is my firm belief that, that we are now working not just on treating the very sick, but understanding the delayed health care becomes a cost and that therefore prevention is an area of huge focus for us.
And that's a very important point you're making, because often we don't see those benefits immediately. They are so long term that the people who made the decision are long out of the system, and now you're reaping the benefits in future generations. And that's a very and also the issue you highlighted about ensuring that you create the efficiencies by ensuring you've got a strong primary system. You know, the US, NHS is the UK, NHS is based on that whole principle of gatekeepers that ensure that you use the right level to improve efficiencies, and you've been focusing exactly on that issue very nicely. So, Ben, tell me from your perspective, you know, you've you deal with technology. You've been talking about the importance of the economy, improving health from your perspective, you know, how can we achieve better healthcare without the costs, you know, getting out of control?
I mean, in short, the answer will be technology, unsurprisingly. Okay. And maybe what you do, but let's discuss offline. Yes. So no, I mean, take a step back. Yeah. So, until I land on that point, I mean, when we look at what are the major killers today, what is the globally the disease burden also in the, in countries like India in the meantime. Yeah, the NCD, the non-communicable diseases have overtaken worldwide as the primary the primary cause of death in 75% of cases. Yeah. And and what they have in common is that they all have a processes. There's a disease process, whether it's Alzheimer's, whether it is, cardiac cardiovascular disease, coronary artery disease, whether it's stroke, whether it's cancer. So there is a process. And that is why the prevention piece is so important, because it means you want to catch that process early. Yeah. Early detection. Yeah. Which is only possible with technology in the end. Yeah. And then you need to make the diagnosis, and from the diagnosis, the therapy decision and maybe therapy simulation and, and then you hand it over to some form of very often technology driven therapy, which is in our case like radiation therapy or in a combined use case, you know, the cath lab with a whatever Medtronic or Boston Scientific device or recommendation of this and this drug. And then looking at, at, at the, you know, does the patient respond or not. Yeah. So, so in, in this pathway, technology is the key topic. And I believe what we are maybe sometimes not fully aware of is, that what we need to do here is personalization. Yeah. Because in infectious disease, in a little bit of a simplified world, it's a one size fits all problem. Yeah. There's a vaccine or an or a antibiotic treatment. Yeah. So I'm super simplifying in the diseases which now are the the burden of humankind and the economy of Europe. Yeah. It's, it's personal what one needs to do. So it's about personalization at scale. And I believe this only works if we really smartly deploy technology from prevention to the right diagnosis to the therapy, without multiplying the human factor and labor going into this process. And this is where healthcare AI plays a role and so on and so on. And that's why I think we cannot solve the NCD challenge without very, very good use of technology. Yeah.
And, you know, you've been talking about this NCD challenge and the way it's going to drive costs. But it also we have an aging population that's contributing to it. And your comment is about so how can innovation feed that that process that improves our ability to deal with it. So I take your point and I and I hear you, you want to just share, you know, an example of how you see that happening. You know, in a, in a real health system.
I mean, in a, in a real health. First of all, we have now technology. So now comes because you asked the commercial break. Yeah, we have technology which basically allows you to see way before a cardiovascular event a myocardial infarction. Is there a danger in the coronary arteries. Yeah. So we can basically what mammography does for breast cancer. We can do basically for every I mean we need a guideline here that every 50 year old plus person should do this. And the sudden cardiac event would be history. Yeah. So the one example the same in lung cancer screening or and now comes the topic how the therapy space. As soon as there are the first drugs for Alzheimer or even if it's just a disease modifying therapy. So the first successes what you need is technology to find out does this, is this dementia really Alzheimer? Is it in a state where it is makes still sense to do it? And then in the next step, you need technology to accompany the treatment to exclude the side effects. Whether you kill the patient with the therapy because of micro bleedings and so on. So I think there's in each of these diseases, there's a strong story to tell how technology makes a difference and where not using technology would probably much more expensive than than doing it. Yeah.
So, Stephanie, tell us how you've captured the essence of the economics underpinning health. And you've heard about, you know, technology, the importance of the way in which, we understand that this investment you also talked about, you know, are we measuring it adequately? Are we assessing return on investment? Share with us some of your research, your understanding about how we might better assess that return?
That's a great question. So, one thing I did want to tell you about very much is, on this public policy angle, a little bit people's perceptions of it, which I think is really, really important. So what we do at the social economics lab, my lab at Harvard, is to really see how people think about and understand economic issues, economic policies and healthcare. The health insurance system is one of them. And let me tell you, just two groups of really interesting findings. The first, which is a little bit us centered, is that there is actually a lot of agreement across people about the benefits of expanded healthcare, expanded health insurance. Most people's key concern is affordability and access. So not having sufficient access and things being too expensive. And there's a lot of agreement that expanding preventive care, which is something that was talked about here, would be really, you know, very efficient, very important, that there's an equity concern to, you know, helping low income families afford healthcare is actually a widely shared concern. So where does the disagreement lie? Well, we see that once we get to the point of talking about concrete policies like should, you know, should there be more Medicare for all type of policies, affordable care. That's when there's very large partisan gaps that appear. So you have very different support based on whether you're a Democrat voter, a Republican voter. And we can trace it back to just fundamentally different views about the role of government in this. So about who should be providing this, the private sector or the government. And it actually goes a little bit hand in hand with some lack of understanding about how much the government is already doing. So there is actually not so much awareness about the extent of these big government programs that are already doing a lot. And when you inform people about them, when you explain, for instance, what Medicare does, what Medicaid does, what research says about their impact, people actually have a bit of a surprise reaction and become much more supportive of such government programs. So I think there's quite a bit of scope there to to foster support by concretely talking about the benefits of such government programs. The second big finding, which is relevant, I think for all countries, it's not just the US. So we studied how trust in science and the medical system has evolved, and unfortunately it has crashed, especially since Covid. So there were already such tendencies. But in general, trust in science, trust in experts more generally has really, really declined. And when there is so much uncertainty in an area like health, right, there is a lot of uncertainty. We don't have the perfect answers. And there is such a decline in expertise in scientists. What happens is that a huge partisan gap appears there too. A big polarization appears. So we see it, you know, in policy views. We see it in what people think should be done, but we even see it in private behaviors. So if we if we look at data of what people do for their private health, in terms of what vaccines they get, how much preventive screening they get, it's incredibly correlated with their political leaning. So something that, you know, should not necessarily be correlated to this important private behavior is actually playing a big role. And so I think there's a lot of scope for more information, for more rebuilding of trust. In, in experts in science in a nonpartisan way to really to really push this forward. So I think the discussion about huge health advances, innovation, all of this is incredibly important. But to have people take it up, to have people be able to afford it, requires quite a bit of government and public policy action.
Thank you so much, Stephanie. I'm going to go to Minister and Minister Watkins. Just share with us. I mean, you've heard now from all of the panelists and you know, you're going to be going back to Germany and to your health care system. You're going to look at what's going on there. Share with us what are the challenges and what what do you see as the way forward, specifically in relation to Germany. So we get a sense of how you see the way forward.
You mentioned it earlier.
I think in order to make progress, to really make our system fit for the future, for this, we need the reform. And this is our approach at the moment. We we need more digitalization for that. We need more cooperation, more networking. We have to make sure that the whole work processes become easier, that there's more time for the patient, that everything becomes more efficient. We have now introduced the electronic patient record. Other countries were quicker. So now you can see what has been done, which examinations have taken place, what drugs are people taking so that people don't have to carry all their results around with them. But everything's there and we introduce this, but we've got to roll it out a lot further, because this is going to help us to ensure that we can have a more targeted treatment of patients. The system will interact a lot more, there will be a better network system, and that will, at the end of the day, also save certain examinations that are maybe unnecessary. People also get a better understanding of what one physician does and what another doctor's doing. So this is digitalization. That's very important. Also looking into, innovations, Mr. Montag mentioned it. It's really important that we look into artificial intelligence, for example, for early detection. There's a lot more possible than we're using at the moment, but we also have to look into how we finance that. And that also brings me back to the topic of prevention. We have to make our citizens capable to understand the system and to understand their life choices and the impact of that on their body. And we have to make them use early detection opportunities. So we will also invest into public measures there and promoting this. And what is maybe different to other countries is that we have to see how we make this more reliable. In other countries, things are a lot more than top down. If I tell people drink less wine or beer, then there's going to be very strong reactions to that. Same goes for eat less sugar. So if we tell people what to do, if we say no ads for sweets on the telly, then on the one hand people think it's a good idea. At the same time, there's going to be a massive outcry because people don't like to be told what to do. So when it comes to prevention in Germany, and that is something that we're going to tackle, is we have to find a better way of dealing with this and make people understand what they have to do. It cannot only be the state that offers things, but our citizens also have to help us with it.
Thank you very much, Minister.
Yeah. You've, you've got a lot on your plate. You know, we. Just know you have our thoughts with you as you tackle them. Because we all are facing many of those challenges. So I'm going to ask for just some very quick, closing comments from our panelists. So let's start with you, Stephanie. Just share some quick thoughts about the way forward solutions, how you see this question.
Two thoughts. One is, I think we need to talk about people who cannot afford healthcare, which is a very large share of the population. So all the great innovations that will be made, all the great preventive care that will be offered, you know, in some sense, public money will need to go into it to help people who cannot afford this. And that's a very large share of the population in many places. The second thought I have is around innovation. You know, I have studied this a lot and a lot of huge, groundbreaking innovations have always happened in a public private partnership. So in the US, DARPA is a great example of really the groundbreaking technologies, because the private sector, again, doesn't have the incentives to go for such incredibly risky, potentially very high return, but also with very large social spillovers technology. And I think in healthcare, that's a, you know, I think in many countries a bit more public private partnership in innovation could be something that could really make a difference.
Sunita. So some quick thoughts.
In India we have Ayushman Bharat, where 750 million people have health records. And and I think that's a huge way forward because the government pays for that insurance for that health care. But looking at today's discussion, I think ROI is very important. It's the return on the quality of life, on return on longevity. It's also a return on sustainable cash flows that you have to invest into the future. My take is that all of us sitting in the room bring so much knowledge and talent. We need to collaborate. Public private manufacturers and private health care institutions to create the next version of health care.
Very well said Ben.
It's hard to put it in a short answer. I mean, I believe that it's very important that we come again from this technology angle, but what is the resonating ground for this? Do we have or is the system too fragmented to to really adopt this. And and there is historically like in Germany, we have this separation of ambulatory care and acute care. So it creates friction. There's the discharge letter, and, and whatever happens. But there's very often there is not enough players who really have the on the agenda of what we discuss here. My life is about making healthcare more affordable. So to say that people wake up to do this, typically people wake up. My life is to to do as much healthcare as possible, and I'm not happy that the reimbursement got cut. So and I'm and you know how it feels. Yeah. Everybody has an interest and so on and so on. Yeah. In in other parts of business in I constantly say business. Yeah. This is what we do. Yeah. There's a chain of hotels, there's Apollo hospitals. Yeah. Where we, where we create a system and optimize and have make the optimization a task. Yeah. So how do we have more people? And not only I don't think health ministers who have at their task. I want to succeed by making it better and more efficient. That's my game. And I think this is a structural topic we need.
Wonderful. Michel. You got.
Yeah, I really strongly believe in private public partnerships. And at AstraZeneca we have taken really a strong stance in that, in partnership with the Ref and with the London School of Economics, to create the partnership for Health System Sustainability and Resilience. You see it on the screen. And so what we're doing, we are financing studies in more than 30 countries in order to really make a full assessment of a health system and come with recommendation, how we can change this balance and turn it into something different. And then we we convey together all the players of the ecosystem and try to find opportunities for the private sector to combine, with the public and the public sector and do it together. So I think if we can do that more and you were talking of NCDs, the latest paper on that is acting early on NCDs. So we're drawing the lessons from each country study that has been made. So I think that has a lot of future. If I can finish with one sentence, the most important asset that the country has is the health of the population.
Well said Michelle. What a what a what a what a concluding statement to make. So ladies and gentlemen, you've heard the esteemed guests tell us about their thoughts on health care. Is it a cost? Is it or is it an investment? And what we heard is the complexity of that relationship, that when we look at health, we've got to look at it as an essential part of our society and an essential contribution to making every one of our countries and the world a better place. We're not going to do that alone. We're going to do that in partnership with all of the different players. We're going to do it across the different stages of health. Looking at prevention, health care, looking at the elderly. And we're going to look at all of those challenges. And innovation has a role to play in each of those different steps and how we use innovation and how we use it wisely, is one of the ways in which we can move forward in a way that sees, technology not only as a driver of cost, but also as a way to help us contain those costs in whatever way we choose to use it. And I think, finally, you all captured very well that every one of us is going to grapple with this challenge in all our different roles, whether we in academia, whether we're running hospitals, whether we're developing technologies or drugs or making those difficult decisions, Minister. And as each one of us deals with it, we can learn from our collective wisdom. And it's that collective wisdom that we have and can bring forth, and which the World Economic Forum is a leading player in helping us share our thoughts and sharing our wisdom. So on that note, I'd like to thank all of the members of this panel. You've been eloquent, you've been succinct, and you've shared with us enormous wisdom that we can take forward. On that note, thank you very much and a very good afternoon. Thank you.