Sustainability of specialized healthcare in upper-middle-income economies: Innovations despite constraints

Countries such as Jamaica have had to be largely self-reliant in funding their health-care systems. The success of an early and sustained focus on primary healthcare, coupled with a change in the disease profile from infectious concerns to chronic non-communicable diseases associated with aging, has resulted in a marked rise in healthcare costs. Rapid technological advances in the diagnosis and treatment of many specialized conditions have further increased the cost of care. Funding these health-care costs sustainably is a challenge for Jamaica and other similarly developed economies due to competing demands for scarce funds. In addition to government health-care allocations, sources of sustainable funding from local public-private partnerships, through mechanisms such as philanthropy, may help address, at least in part, this chronic problem. This review examines strategies to create a framework for such funding, as well as proposes specific practical steps for their achievement. The author’s motivation to participate in the process of change stems from the stubbornly persistent inequalities of healthcare that people and health-care workers in Jamaica – and similar lower- and middle-income countries – routinely cope with. These inequalities must be addressed to truly achieve greater health egalitarianism, social stability, and ultimately, the developed country status they aspire to. The need to think innovatively to achieve this goal is self-evident, given the current inability of governments to achieve this goal.