Misaligned Stakeholders and Health System Underperformance

David Bloom, Daniel M. Cadarette (), Jonty Roland and Jessica Sullivan ()
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Daniel M. Cadarette: Harvard T. H. Chan School of Public Health
Jonty Roland: KPMG
Jessica Sullivan: Harvard T. H. Chan School of Public Health

PGDA Working Papers from Program on the Global Demography of Aging

Abstract: This paper summarizes the findings of the World Economic Forum’s Industry Agenda Council on the Future of the Health Sector’s two-year inquiry into underperformance of health systems. The Council found that misalignments (i.e., situations involving conflicting incentives, behaviour, structures, or policies) among key stakeholders are likely to lead to significant waste, whether measured in terms of health for money or money for health. This paper defines three types of misalignments (those due to divergent objectives, power asymmetries, and cooperation failures), offers concrete examples of each type, and includes several cross-cutting examples from three particularly burdensome disease areas: cancer, diabetes, and mental health. The Council also examined situations in which stakeholders acted to correct misalignments and reduce waste. This paper details several case studies of achieving greater alignment and enumerates a set of lessons for stakeholders. It concludes by making recommendations for future research in this domain. JEL Codes: D47, D49, I11

Keywords: Misalignment; alignment; incentives; health; healthcare; divergent objectives; power asymmetries; cooperation failures (search for similar items in EconPapers)
Date: 2017-01
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