European healthcare is under the microscope right now. With savage cuts in the wake of the eurozone crisis, will Europeans be forced to abandon cherished public healthcare models? Or are there ways to save universal healthcare in the face of shrinking budgets?
In Greece, new austerity measures now mean that if a person remains unemployed for longer than a year, or if they owe any money to the government (even a parking ticket), they lose their entitlement to state-funded healthcare coverage. With official unemployment figures higher than 22% (and with youth unemployment already above 50%), this means hundreds of thousands of Greeks are being forced to attend free clinics (often run by charities) for basic medical care. Since 2009, the Greek healthcare budget has been slashed by 13 percent, and a new fee of €5 for hospital visits has been introduced.
Spain, meanwhile, has likewise seen falling hospital budgets and rising prescription costs, whilst the country’s Industry Minister, Jose Manuel Soria, recently told Spanish state television that it was “time we end the culture of everything for free.” In Italy, cuts of 8 billion euros are planned for the healthcare system over the next two years. In fact, a recent OECD report found that growth in healthcare spending all across Europe (which had been rising for much of the 2000s) is now grinding to a halt and, in the worst-affected countries, even going into reverse.
Whilst many of the comments you’ve sent us on this topic have called for the “European social model” to be protected, we’ve also had comments arguing that we need to be realistic about what we can afford. Fabian, for example, sent us in the following:
I’m not suggesting that we directly eliminate all these services, but rather that we start a public debate on which services we want the healthcare system to cover and which services should be privately paid for. Fostering and moderating this discussion throughout Europe should be a top priority for European policy makers.
We arranged a Skype video interview with Paola Testori Coggi, Director General for Health and Consumers at the European Commission, and asked her to respond to this comment. Is it time for a debate on what level of public healthcare Europe can really afford?
Ms Testori Coggi was adamant that Europe did not need to abandon its “social model”, but nonetheless argued that greater efficiency was needed:
The social model of Europe, which guarantees access to high-quality healthcare, is a good model and we should not put this in doubt… [but] we need to ensure that public spending is more efficient.
Some of you have sent in comments arguing that advances in health technology might help increase efficiency and drive down costs without reducing the quality of care. However, we’ve also had a couple of comments cautioning against seeing technology as a “magic bullet” to solve all our healthcare problems. Eric, for example, argued that limited resources are better invested in primary health care:
Spend the money and technology on reinforcing access to primary health care (as promised in the Millennium Development Goals anyway) and in the long run, the health care dollars will go a lot further.
But does an emphasis on a technology-driven approach risk privileging that part of the population most able to afford (and most familiar with the use of) new technology? David, another commenter, argued:
Concentrating on that small part of the population with access to medical technology overlooks the real risk in the system that starts in the doctor’s office.
Finally, might a greater emphasis on prevention and healthier living help drive down costs? We had a comment from Enrique arguing that:
We must [increase] the health level of people through better regulation of the agri-food sector to produce food that maintains long-term health, instead of food 80% depleted in vitamins.
What do YOU think? Will austerity force Europeans to abandon existing public healthcare models? Do we need an open debate on the alternatives? Or could steps to improve efficiency in the system help save univeral healthcare? Let us know your thoughts and comments in the form below, and we’ll take them to policy-makers and experts for their reactions.
Paola Testori Coggi is Director General of the Directorate-General for Health and Consumers of the European Commission.