The European Commission and the OECD have issued a warning: if political decision-makers do not reorientate their spending on health now, they will be in danger of having to confront high costs over the next few years. This is the message from the two institutions in their joint report published on 23 November.
The paper, “Health at a Glance: EUROPE 2016” provides the most recent trends on health and health systems in the 28 member states of the EU, 5 candidate countries and the 3 countries of the European Free-Trade Association.
Significant differences. The observation is staggering: although life expectancy has increased by an average of more than six years in EU member states (from 74.2 in 1990 to 80.9 in 2014), disparities persist between the different countries and within them. The differences between EU member states can partly be explained by the degree of investments made by member states: therefore, health spending is generally higher in the western part of the Union, where people live on average eight years longer than in countries of Central and Eastern Europe where life expectancy is lowest. Germany, Sweden and France all invest 11% of their respective GDP, as opposed to 5-6% for the countries in the eastern part of the EU (only 3% is earmarked for public health campaigns and prevention). The differences within the different countries themselves coincide, partly on the basis of variations relating to education levels: people with low levels of education live on average seven years less than people with higher levels of education.
Common challenge. Despite these differences, all the different countries in the future may have to confront the risk of high health spending, mainly due to the effect of ageing populations and the introduction of new technologies for diagnosis and treatment. In this context, the European Commission and the Organisation for Economic Co-operation and Development (OECD) is recommending that member states improve access to primary health providers and begin investing in prevention measures.
On the question of access, the report encourages the member states to cover a maximum number of people and different kinds of healthcare; that it covers a maximum of the costs involved and ensures that health care providers are sufficiently represented and diversified throughout the different geographical regions. It is recommending, for example, that Cyprus, Greece, Bulgaria and Romania introduce universal coverage of the costs for all basic services, given that even in 2014, more than 10% of their respective populations were still without health cover.
On the issue of prevention, the report emphasises that a significant number of people die every year from preventable diseases linked to risk factors such as smoking and obesity. Despite significant progress, one out of five adults in the EU continues to smoke on a daily basis and the same proportion consumes high levels of alcohol at least once a month. It is also noted that one of six adults is obese.
Mr Angel Gurría, the OECD Secretary General, concluded “We need to orientate resources where they have the most impact on healthcare results, such as prevention activities”. The report can be consulted at: http://www.oecd.org/health/health-systems/health-at-a-glance-europe-23056088.htm. (Original version in French by Sophie Petitjean)