All Western countries face a growing challenge in healthcare: demand is rising due to an ageing population and ongoing technological innovation, while at the same time, the supply of healthcare workers is shrinking. This imbalance is not temporary or isolated; it seems to be structural and systematic. It forces us to rethink how we organise care, how we allocate resources, and what we define as good policy.
In his inaugural lecture, Misja Mikkers spoke about the challenge that presents an opportunity, an opportunity to shift focus from equal access to healthcare to equal health outcomes. Research consistently shows that the main drivers of health lie outside the healthcare sector: poverty, education, housing, and social conditions all lead to chronic diseases and health inequality. The solution is not to spend ever more on healthcare, but to invest in what actually improves outcomes. Better results come not from doing more of the same, but from doing different things and doing the right things. That means rethinking how we collaborate across sectors, how we align incentives, and how we enable systems to learn and adapt.
This text builds on Mikkers' inaugural lecture at the University of Twente, where he argued that many healthcare reforms fail not due to a lack of effort or insight, but because they treat problems in isolation. Fragmented responsibilities, poorly aligned incentives, and nonexistent or slow learning cycles make it difficult to provide coordinated, patient-centred care. Addressing these challenges requires a shift in perspective.
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