“To help the hospital by moving the center of gravity of our health care system to the home”

dFrom Athens to Stockholm, from Lisbon to London, the international picture of health systems is worrying. If we take a step back, the observation is clear: the population is aging and requires more and more care. Health care costs are now changing faster than GDP, and public and/or private insurers everywhere are pressuring providers—city professionals and health care facilities—to achieve productivity gains and ultimately savings to ensure their sustainability.

The increase in demand for care is de facto linked to the search for increased productivity. The latter leads caregivers to reduce the time they spend interacting with the patient, which is at the heart of their professional calling. This is the main reason for the crisis in the importance of health professionals in France and in all Western countries.

Thus, the World Health Organization continues to warn about the worrying prospects of vacant jobs for health professionals by 2030. This professions crisis preceded the Covid health crisis, but the latter has intensified. There is now a contradiction, both paradoxical and troubling, between the acceleration of medical progress—an element of important progress—and the deterioration of training conditions for professionals. For example, healthcare innovation makes it possible thanks to immunotherapy procedures (at an average of 400,000 euros per patient in Medicare) to transform cancer, which yesterday was still very aggressive, into a chronic disease.

Given these medical and scientific possibilities, the same state-of-the-art hospitals that offer this treatment to the entire population suffer, for example, the impoverishment of their information systems, which are currently lagging behind the digital revolution, with consequences for work ergonomics for professionals.

Health professions, which were one of the most sought after in our societies in the 20th^e century, will they be gradually neglected professions in the 21st?^e century? Faced with this historical trap, health system leaders today have an ethical responsibility to be, in turn, a source of suggestions for professionals, patients, and public authorities.

A new profitable equation

In this, unfortunately, quite homogeneous international picture, our country still experiences specificity. For more than twenty years, frontline care has been unable to cope with an aging population and the growing burden of chronic disease. Over the course of a generation, the hospital saw its core business continually expand, to the point of taking on activities beyond its own. He has become the craftsman of the health care system, which in turn forces society to ask him for new productivity gains…