Health care and macro-economics in Europe

video and audio recording

Event Materials

Presentation of Zsolt Darvas

Presentation Xavier Prats Monnee

SUMMARY

The panel presented two novel contributions in the field of health policy: on one hand the 2017 “State of Health in the EU” and on the other a Bruegel paper on the “Macroeconomic implications of healthcare.”

A starting point during the discussion of both contributions was that money does not mean everything in healthcare. Indeed, mean per capita expenditure on healthcare correlates positively with improved health outcomes at low levels of spending, but the relationship disappears beyond a certain threshold. This is why policy discussions over the past 2 years have therefore gone beyond what is spent towards how it is spent.

This is of course a much more challenging aspect, as policy-makers need more granular indicators than health outcomes to measure efficiency. How to better measure the quality of care was therefore a key question. Some of the discussants highlighted how current healthcare data policy led to inefficiencies and foregone opportunities for R&D. Another factor was that so far, comparative and unambiguous indicators were absent from the policy discussions.

However, the panellists looked forward to the positive developments in that direction, notably the Patient-Reported Indicator Survey (PaRIS) that has the potential to properly address the issue of measuring efficiency. The discussants also highlighted the high acceptance across countries of the metrics used in the “State of Health in the EU” to assess and compare their health systems. This acceptance of metrics used has also been key for the success of DG ECOFIN’s joint report on Healthcare and Fiscal Sustainability. There is hope that the high acceptance and policy-relevance of these indicators will lead to informed domestic reforms.

Beyond its measurement, other points related to efficiency were the importance of prevention, the role of inequalities and the EU added-value in the policy decision. Discussants agreed that prevention was currently underfunded relative to curative and rehabilitative care. This is one of the main conclusions of the State of Health in the EU. However, a fundamental issue is that while there is an economic case for prevention, there is no business case for prevention.

Inequality of access and income inequalities were also highlighted in the discussion, as cause and consequence of each other and of inefficient spending. The poor health of a minority of citizens with unmet healthcare needs have macroeconomic implications EU-wide and greater access could be avenue for greater efficiency. This is one of the common challenges that the EU could help address by transferring best practices. Another way the EU could add value for domestic health ministries is by promoting other best practices such as Health System Performance Assessments and Health Technology Assessment, or guidance for transition towards E-health and integrated healthcare systems.

Event notes by Nicolas Moës, Research Assistant.