Rethinking Health System Design: Towards a High Value Health System Model

Abstract

This position paper discusses a major, and arguably one of the most critical developments in comparative health systems: the transition towards a high value health system model. High value health systems have one goal: to produce impact, at scale, for entire populations, over the long term by creating “value for money and value for many.” The paper draws on major theoretical research, empirical data, unpublished perspectives, and country experiences to provide a critical review of the literature in comparative health systems to develop the empirical basis and rationale for high value health systems. The paper is organised in three sections. Section one focuses on the current state of and major shifts that influence contemporary health systems and discusses the current signs of systems fatigue. In section two, we build on this analysis and outline each of the ten components that need to be in place to establish a high-value health system and discuss illustrative examples from G20+ countries that have used one or more of these components to transition to high value health systems. In the third section, we provide a strategy to help countries to transition to a high-value health system model.