Health Policies & Nudges: Reflections Before the Next Pandemic

Abstract

What has been experienced during the COVID-19 pandemic, especially in the most vulnerable populations, has revealed the need for a new health model, much more fair, efficient and inclusive; However, defining and applying it is particularly a complex task. When the pandemic arrived, health systems in different parts of the world revealed their precariousness and inequality, exacerbating the vulnerability of some groups. To make matters worse, the international response once the crisis arrived revealed limited solidarity in the most difficult moments of the crisis. Although the arrival of vaccines months later offered hope, demonstrating the importance of collective work and not the fate of nations, many people, for reasons of the most diverse nature, were reluctant to get vaccinated. So, governments, faced with the urgency of confronting the virus in the most massive and rapid way, dictated different measures, sometimes correct, sometimes controversial, with the purpose of promoting vaccination. This intervention, beyond its results, should raise questions about the scope and limits of state intervention in health, what are the terms that the relationship between the individual and the State should have, the need for subtle measures to motivate vaccination and the possibility of applying nudges as a strategy for the effect. The experience of the pandemic, with its millions of victims, raises the need for a global and autonomous model, taking advantage of globalization to access knowledge, produce medicines and vaccines, as well as distribute them in the most efficient way. In this purpose, science plays a crucial role, even when its postulates are provisional. States must rebuild lost trust in their governments, and know how to balance health and the economy. The pandemic has highlighted the importance of global public goods and the need to reconcile personal and collective interests instead of opposing them. Lessons include the need for universal health systems, balanced measures by the State and the promotion of both a culture of responsibility and an ethic of care, with persuasion preferable to imposition. This article certainly does not seek to propose what this system should be, which requires deeper and more interdisciplinary work, but it does seek to propose some guidelines that serve as guidance in this task, based on reflection on the experiences lived in the fateful days of the pandemic.