Healthcare systems around the world are under increasing strain, facing rising costs, demographic change and accelerating medical innovation. The seventh edition of Roland Berger’s Future of Health study – based on a comprehensive best practice analysis and a global survey of more than 5,000 respondents across 25 countries conducted in 2025 – shows that reform is urgently needed to bridge the gap between old structures and new realities. In the study, we identify the principles of high-performing systems: genuine equity, strong coordination of care, effective digitalization, prevention-oriented public health, efficient use of resources, agile transparent governance and transformative innovation. But as health systems evolve, one question remains: How can they balance shared values with local realities – and design models of care that truly reflect what citizens expect?
The case for change in today’s healthcare systems is clear. Globally, health spending is rising faster than economic growth, yet inequities in access and outcomes persist. Aging populations and the growing burden of chronic disease are reshaping demand, while workforce shortages – the World Health Organization is projecting a global shortfall of 11 million health workers by 2030 – combined with outdated governance structures constrain supply. Meanwhile, advances such as cell and gene therapies and GLP-1 agonists are transforming the possibilities of care, but few systems are currently equipped to adopt them at scale. These pressures reveal a systemic misalignment and the need for a comprehensive rethinking of how healthcare is structured, financed and delivered.
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What do the world’s best healthcare systems strive for, and how do they get there? Our research shows that high-performing systems share a distinctive set of levers that allow them to achieve better outcomes while using resources efficiently. Specifically, they align financing, service delivery and governance around fairness and access. Clear coordination connects prevention, treatment and recovery, ensuring that care functions as a unified whole rather than through isolated institutions. For example, Denmark’s digital infrastructure and Singapore’s primary care networks show how coherent design and accountability can turn strategy into results. And when systems combine integration with transparency, they not only improve performance but also reinforce public confidence in the value of healthcare.
The evidence indicates that excellence depends less on financial capacity than on adaptability and focus. Thus, systems that monitor outcomes and use data effectively are better able to respond to demographic change and fiscal pressure – especially if they invest in their workforce at the same time. Often, resilience grows through the ability to turn innovation into daily practice: In countries such as Estonia, for instance, digital tools have been successfully embedded into clinical workflows, improving efficiency and patient access. Others, like Japan, have strengthened coordination between hospitals and community care to meet the needs of an aging population. Importantly, rather than copying any single model, systems should draw on the underlying principles of high performance and adapt them to their own national priorities and realities.
Our survey paints a clear picture of what people across diverse countries value most when it comes to healthcare. When asked whether everyone should receive the same care regardless of income, or whether those who pay more should get faster or better treatment, a clear majority – 61 percent – support equal access for all. Similarly, when faced with a trade-off between fairness and speed, 57 percent say they would accept longer waiting times if it ensured equality of treatment. Respondents also show strong support for publicly funded systems that provide full coverage; they believe that affordability and inclusion are the key to fairness and trust in healthcare.
Beyond equity, the survey reveals that people want systems that combine progress with human connection. Respondents across countries expressed strong approval for digitalization, but most also stressed the importance of keeping personal interaction at the center of care. There was a clear preference for prevention and self-responsibility, but 68 percent opposed sanctions for unhealthy behavior. Over half of respondents favored early access to innovative treatments such as new biologics and gene therapies, yet opinions were split on priorities: 52 percent preferred to target diseases with the greatest impact, while 48 percent favored those affecting more patients. Overall, the results indicate a global desire for health systems that are modern, fair and humane.
Turning these insights into lasting impact requires coordinated action. For policymakers, we recommend moving from crisis response to long-term system design, while at the same time investing in prevention, integration and workforce capability. This will mean setting clear objectives and linking financing to measurable outcomes. For commercial players – including providers, pharmaceutical firms and digital innovators – the priority should be to combine innovation with accessibility and trust. Transparent partnerships and investment in solutions that improve both affordability and efficiency are essential. Our conclusion? Only by aligning public policy with private innovation, and by keeping trust and equity at the center of reform, can we build healthcare systems that are ready to meet the future.
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