Key strategies for addressing the rising global burden and cost of healthcare

Abstract

The continuous rise in healthcare costs has become a global concern, posing significant challenges to both developed and developing nations. This upward trend is driven by various factors, including an aging population, advancements in drugs and medical technology, the increased prevalence of chronic diseases, and the growing demand for personalized care. As healthcare expenditures escalate, the financial burden on individuals, governments, and healthcare systems intensifies, raising questions about the long-term sustainability of current healthcare models. This paper, based on a narrative review of the literature and informed by the author’s perspective, explores alternative approaches to healthcare delivery aimed at alleviating this burden. Four critical strategies are recommended: curing diseases, not just treating them; enforcement of healthy foods and drinks; empowering individuals to take active roles in managing their health; and improve and sustain country and people economically. By understanding and addressing these fundamental aspects, it is possible to create a more sustainable healthcare system that can better withstand growing financial pressures, ensuring accessible and effective care for future generations.

Background

The healthcare system plays a crucial role in maintaining the well-being of populations by preventing and treating illnesses. However, the rising costs associated with healthcare are an increasing concern. ¹ Chronic diseases such as diabetes, cancer, and kidney disease are on the rise, further driving up healthcare expenditures. In the United States, healthcare spending is projected to reach $6.2 trillion by 2028, accounting for 20% of the GDP, while the global cost of chronic diseases is expected to reach $47 trillion by 2030.^2,3 For example, in Malaysia, the estimated incidence and prevalence of end-stage renal disease (ESRD) are projected to double by 2040 compared to 2020 levels. ⁴ This alarming trend places a significant burden not only on the government but also on individuals seeking treatment.

In Europe, the economic burden of chronic diseases is also substantial. According to the European Commission, chronic diseases account for 70%–80% of all healthcare costs, amounting to approximately €700 billion annually across EU member states. ⁵ This alarming trend places a significant strain not only on governments but also on individuals seeking treatment. Similarly, in Africa, the growing burden of non-communicable diseases (NCDs) is putting immense pressure on already limited healthcare resources. According to the World Health Organization, NCDs are expected to overtake communicable diseases as the leading cause of death in sub-Saharan Africa by 2030. ⁶ This concerning situation is likely to have serious economic implications for the region, as managing NCDs involves substantial costs.

The rising cost of healthcare places a significant strain on individuals, particularly those requiring ongoing treatment for chronic conditions. ⁷ Many people struggle with high out-of-pocket expenses, insurance premiums, and unexpected medical bills.^8,9 This financial burden often forces difficult decisions, such as whether to pursue treatment or forgo necessary care. ¹⁰ Studies have shown that increasing healthcare costs can negatively affect individuals’ quality of life.^11,12 Therefore, it is imperative for governments to take proactive measures to address these escalating costs and reduce the financial burden on their citizens.

What has been done so far?

Several initiatives have been implemented to address the rising healthcare costs, focusing on governance, preventive care, and improving healthcare delivery efficiency.

Governance initiatives

Some countries, such as those in Europe, have adopted universal healthcare systems to control costs while providing comprehensive coverage. ¹³ Meanwhile, many Asian countries employ a dual system with both public and private healthcare sectors. Looking at the pattern of healthcare costs is continuously increasing, people may need to pay high taxes in order for government to incur the healthcare costs and sustain its healthcare delivery.^14,15 On the other hand, governments can manage costs by negotiating drug prices, encouraging the use of generics, and leveraging purchasing power to secure lower prices from pharmaceutical companies.^16–19 These steps aim to reduce medication costs while ensuring access to necessary drugs. ²⁰

Public health prevention

Investments in preventive measures like vaccinations, screenings, and health education can reduce chronic disease incidence, ultimately lowering overall healthcare costs.^21–23 For instance, early cancer detection through screening has proven to reduce long-term medical expenses and improve patient outcomes. ²⁴ Some countries, including Japan and Korea, have implemented nationwide screening programs with success, though the initial costs of such programs can be significant, especially in developing nations.^25,26

Enhancing healthcare delivery efficiency

Telehealth has emerged as a valuable tool to improve healthcare access, particularly for underserved populations in rural areas. It reduces travel costs and patient waiting times, offering cost-effective care. ²⁷ The increasing use of digital technology and AI can streamline patient management, contributing to earlier diagnoses, such as using smartphone apps for oral cancer screening. This use of technology can further reduce healthcare costs while improving patient satisfaction. Perhaps, among the blessing from COVID-19 pandemic is the high user for telehealth medicine.^28,29

Additionally, deep learning artificial intelligence is expected to play a growing role in diagnosing and managing glaucoma by utilizing data gathered from telehealth services. ³⁰ In addition, the rising use of smartphones presents an opportunity to leverage digital technology such as for screening the early detection of cancer. For example, a study aimed at evaluating the feasibility of using Mobile Mouth Screening Anywhere (MeMoSA^®) for early detection of oral cancer demonstrated its potential to promote equitable healthcare and streamline patient management, ultimately leading to earlier diagnosis of oral cancer.^31,32

Can we improve?

Despite various initiatives, healthcare costs remain a persistent issue. Increasing demand, an aging population, the rise of chronic diseases, and advancements in medical technology continue to drive costs upward. To truly manage rising healthcare expenses, there is a need for more comprehensive and sustainable solutions.

Curing diseases, not just treating them

One key solution to reducing healthcare costs lies in developing medications that cure diseases rather than merely treating or controlling their progression. This approach is especially critical for chronic conditions, such as diabetes mellitus, hypertension, and dyslipidaemia, as well as for more severe diseases, including end-stage renal disease, stroke, heart disease, and cancer. Instead of relying on current medications that maintain health by managing symptoms or slowing disease progression, future drugs should strive to eradicate the disease entirely. For example, while some medications effectively control markers like blood glucose or cholesterol levels, they often bring long-term side effects and ultimately fail to cure the underlying condition.^33,34 Scientists and pharmaceutical companies bear the responsibility of researching and developing improved medications that aim for a cure. Exploring alternative treatments beyond conventional medicine is another promising avenue for addressing chronic illnesses.

Among the most well-known forms of alternative medicine is homeopathy since it is worth considering why homeopathic medicine has endured for centuries and continues to attract new users.^35–37 Furthermore, a growing number of peer-reviewed scientific journals indexed in Scopus and Web of Science acknowledge homeopathy’s potential, supporting continued exploration into its benefits. ³⁸ It’s essential to clarify that the intention is not to suggest homeopathy as a replacement for conventional medicine. A thoughtful question arises: if homeopathy holds potential benefits, could it be considered as a complementary approach within our healthcare system? Exploring this possibility would require careful and comprehensive research, appropriate regulation, and meaningful collaboration between conventional and alternative medicine practitioners to ensure that patient care remains safe, effective, and grounded in sound scientific evidence.

Enforcement of healthy foods and drinks

Previously, the discussion focused on potential approaches to treating chronic diseases, which are among the leading contributors to high healthcare costs. ³⁹ Now, it is crucial to explore one of the most effective strategies for reducing these costs, which is prevention by addressing the root causes of diseases. While earlier sections outlined some government-implemented prevention strategies, there remains a great deal more that governments, stakeholders, and the public can contribute. The first step is to understand why chronic diseases are occurring. One significant factor is poor dietary habits, often involving the consumption of unhealthy foods and drinks, such as those high in sugar, trans fats, processed meats, refined grains, and artificial additives.^40,41

When individuals consume large amounts of unhealthy foods and drinks, they not only fail to meet essential nutritional needs but also expose their bodies to harmful substances that can disrupt metabolic processes and increase inflammation.^40,41 Excess sugar, for instance, contributes to obesity and increases the risk of insulin resistance, which can eventually lead to type 2 diabetes. High sugar intake is also linked to increased triglycerides, a type of fat in the blood that raises the risk of heart disease.^42,43 Thus, focusing on healthier dietary habits is a crucial component of any effective prevention strategy for reducing chronic disease and healthcare costs.

Governments worldwide have implemented various initiatives aimed at controlling poor dietary habits and promoting healthier eating to curb the rise of chronic diseases. Key strategies include public health campaigns to raise awareness about healthy eating, regulations mandating clear nutritional labeling, taxes on unhealthy foods and beverages, subsidies for healthy foods, restrictions on junk food advertising, and the introduction of healthier school meal programs.^44,45 While these efforts have had some positive impact, the incidence and prevalence of chronic diseases continue to rise, indicating that current public health measures may not be sufficient.

Despite these initiatives, unhealthy dietary habits remain widespread, suggesting that these previous interventions require further refinement and enhancement. To achieve more effective results, governments may need to consider even more proactive and stringent policies. A more comprehensive approach might include broader restrictions on unhealthy food marketing, expanded subsidies for fresh produce, promote substitute healthy foods replacing crystal sugar for instance, ban serious unhealthy foods, and greater integration of nutrition education into school curricula.

Empowering individuals to take active roles in managing their health

This paper has discussed the various roles that governments and stakeholders can play in promoting healthy food and drink choices as part of effective prevention strategies. However, the success of these initiatives ultimately depends on the public’s willingness and ability to adopt a healthy diet. Therefore, any strategy must focus on empowering individuals to make informed choices. Without such empowerment, even the most well-designed prevention strategies risk becoming ineffective. Unfortunately, many people only begin practicing a healthy diet when they are already ill or start experiencing negative symptoms.^46,47 Our goal should be for everyone to understand the importance of health and nutrition and have the discipline to consistently include only healthy foods and drinks in their diet. But is such an aspiration truly achievable?

A critical factor is education and empowerment, which should ideally start as early as possible. Building awareness should begin in early childhood education and continue through higher education. In early life stages, dietary choices are typically influenced by parents and family. ⁴⁸ However, as individuals reach adolescence and adulthood, they gain autonomy over their food and drink choices and may consume whatever they desire without parental guidance. This is why a comprehensive, lifelong strategy is needed to empower individuals from childhood through adolescence. Existing and new strategies in education curriculum must be reviewed, refined, and strengthened to ensure effectiveness.

If governments cannot prevent industries from producing high-sugar beverages, educating the public to reduce sugar intake can be one of the most effective alternatives. Some argue that prevention strategies could negatively impact businesses, particularly those that manufacture and promote sugary foods and drinks. However, if people are well-informed and prioritize their health, food and beverage industries will naturally adapt. For example, as more consumers become health-conscious and reduce sugar intake, industries will respond by creating, promoting, and selling healthier products to meet this demand. In short, empowering the public through education, awareness, and support not only aids in combating chronic diseases but also promotes a shift in market trends toward healthier options. With the right guidance, people can be encouraged to adopt a healthy lifestyle proactively rather than reactively, helping to make these prevention strategies more impactful and sustainable.

Empowering individuals is not merely about avoiding unhealthy foods and beverages. It also involves the deliberate consumption of nutrient-dense foods that support optimal physiological function and strengthen the immune system. ⁴⁹ Therefore, public health efforts should not only focus on restriction but also emphasize the importance of positive dietary inclusion. Thus, education and empowerment play a pivotal role in this process. By equipping individuals with evidence-based knowledge about nutrition and the health consequences of dietary choices, they are more likely to adopt and sustain healthier eating behaviors. Although this effort may take time, some countries such as Japan have demonstrated that it can be successful.^50,51

Improve and sustain country and people economically

One of the final strategies presented in this paper emphasizes the importance of strengthening the economy at both national and individual levels. As healthcare costs continue to rise, it is crucial for people to have the financial capacity to access essential health services and medications independently. Economic resilience empowers individuals, enabling them to afford treatments and preventive care, either through health insurance coverage or direct out-of-pocket payments, thus reducing their dependency on publicly funded healthcare services. Wealthy Islamic countries, such as the United Arab Emirates, Qatar, and Kuwait, provide free healthcare services for their citizens, while expatriates are typically covered by health insurance.^52,53

By increasing the people’s economically, the proportion of people that able to access private healthcare can be increased. If majority of the population have the purchasing power for healthcare in private sectors, the government could foster a more balanced and sustainable healthcare ecosystem, reducing dependency on public systems and allowing them to concentrate resources on essential healthcare services or programs.^52,53 This shift would create a better balance between public and private healthcare, alleviating pressure on government-funded resources. As more people gain the means to access private healthcare, the public system can refocus its resources on supporting vulnerable groups and enhancing overall service quality. This strategic approach could ultimately promote a more inclusive, resilient, and accessible healthcare system that benefits all citizens.

Conclusion

Addressing the rising costs of healthcare requires a multi-faceted approach that focuses on governance, prevention, and sustainability. While current initiatives have made some progress, the issue of escalating healthcare costs will persist unless more comprehensive reforms are implemented. Key strategies should include shifting from treating chronic diseases to curing them, enforcing healthier dietary habits, educating the public, and improving economic resilience to ensure better access to healthcare. By implementing these strategies, healthcare systems can become more sustainable and equitable, improving global health outcomes and managing costs more effectively.