Last year, we asked you whether you thought Europe could still afford the ‘European social model’ in the face of biting austerity cuts. With the election of François Hollande as French President and the kick-back against austerity in the recent Greek elections, do you think things have changed? Is the European social model going to struggle through, or is it unlikely to survive without serious reform?
We spoke to Dr. Miklós Szócska, the Hungarian Minister of State for Healthcare, and put some of your comments to him. Firstly, we asked him to react to a comment from Paul, who argued: “We must not allow neo-liberalism to destroy the European social models. Over the years, there have been attempts to dismantle it always using costs, misuse/abuse or demographics as reasons.” How would you respond to Paul? Is the European social model sustainable?
I think it has to be sustainable, because it is an achievement in civilization. I agree with Paul that it is under threat and facing serious challenges, because on the world market we have to compete with countries that do not have such a social insurance cost-burden. But we have to be able to defend solidarity and the European social model in the coming years.
On the other hand, we had a comment from Fabian arguing that we need to start discussing serious healthcare reform in Europe: “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.“
Yes, I fully agree with him. And this is what we wanted to achieve during our EU Presidency. What we said is that, while the health services are in the national policy domain, there are serious questions that can only be answered at the European level. So, I fully agree: there has to be a European health policy debate, and it will end up with a European health policy in future.
Next, we had a comment from Eric warning that there are no magic technological solution to the problems Europe is facing. He argues that there is “a natural tendency for companies to focus on those technologies that can be marketed to those who can best pay for them. Do we think that personalised medicine will really benefit everyone? I don’t think so, because we need to provide uniform access to basic health care services to everyone first.“
Whatever we do, European societies are ageing and chronic diseases are increasing, and the burden of these diseases will only increase over the coming decades. Where technology comes in is that we have to make clever investment choices. We have to invest in primary care and prevention, so we have to forget the traditional hospital-based model. And technology can help us to make more efficient choices.
In Hungary we are using data in a very efficient way; we are using electronic care-mapping applications to help us redesign patient pathways. So, we can use IT for supporting decisions and to have more efficient health services.
There is still a problem of access, though, isn’t there? 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.“
Yes, there is a risk in terms of equal-access to high-tech services. We have care maps that show that in certain regions, when there are university hospitals, you can see that access to high-tech services is higher than in remote areas. Also, when you look at diagnosis, there is inequality in Hungary in terms of access to high-tech oncological diagnostic services. So, I agree that you have to be very careful and design those patient pathways in an equitable way.
Finally, Patrick had a suggestion for making public healthcare in Europe more accountable: “We could even elect managers and unelect them as soon as they step out of line, to carry out the simple task of managing the paperwork for us.“
There was a time in Hungary, back in 1993, when the hospital staff were able to elect their hospital director. I have to tell, it was not necessarily good for the sustainability of the system. Our experience was that electing the managers endangered the sustainability of the system because they only wanted to take actions in favour of their constituency. So, I fully agree that there is an issue around the accountability of managers in publicly funded systems, but we have to find other ways of supervising the sustainability and efficiency and transparency of these systems than just electing the managers.
What do YOU think? Can the “European Social Model” survive? Might technological innovation provide a solution? Or are we heading towards a future where only the rich can afford the best healthcare? And is the “European Social Model” an achievement of civilization worth protecting, or a clunky and inefficient holdover from a time when Europe didn’t need to compete on the world stage? Let us know your thoughts in the form below, and we’ll take them to policy-makers and experts for their reactions.
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i think , its dead …. goodbye EU
European social model could survive the crisis with no problems – i mean come on, we live in times when we produce more than ever in history, why shouldnt we be able to support our social model? The only 2 threats i see are richest top percent (or better fraction of percent) hoarding their wealth, and (sometimes extremely) poor organization which allows for billions to evaporate into thin air through corruption and ineffective practices.
Humn er?forrs is szksges a technolgin kvl.Az orvosok s az polk ne legyenek tl terhelve.T
To assess the question I would like to see national or regional index of: “(private wealth – privat depth) / public depth”. Do we know how that index looks like?
Yes Europe can save any social model it chooses to save, but many social models are the domain of sovereign nations, sovereign budgets and often part of domestic policy manifestos in electioneering.
Thus, with those social models, what’s chopped. scaled back, budget neutral or increased is a sovereign matter decided (in theory) by the national electorates.
That may well change for those unfortunate enough to firstly have to submit their budgets for checking by commissioners who are not directly elected by the citizenry and secondly if EU mission creep is allowed to take over such policy matters.
One has to ask, when budgets and social policies, joint defence agreements/EU defence forces, EU foreign policy etc are removed from the sovereign realm and governments democratically elected, aside from making new domestic laws, what will really be left to vote for domestic politicians for?
In such a calamitous time where there is a real, tangible lack of imagination from the EU and national leaders which has led to several years of inward examination, you would think that our chinless wonders from around the continent would have sat down and deliberated exactly what, how and who the EU is going to be, looking beyond the Euro, austerity and fiscal pack which will actually change nothing in its current form.
The national leaders must think very carefully about what they will give up to Brussels as soon there will be no point in voting for them when they have so little policy to play with independently.
We may as well just have technocrats…..oh, Italy has already got the ball rolling.
I believe, that the future of European healthcare will have to change a little, but with the proper modifications the “European Social Model” can survive. Obviously the so called French social model is not sustainable in the long run and this present economic crisis is showing that. However, if the burden of the healthcare spending can be shared more evenly between patients and State, then we can maintain the an European social model.
Note that when I say, healthcare spending, I am not saying that patients have to spend more money or pay more taxes, but instead they should rely on a more preventive healthcare,saving resources from State that will be available when they really need. The veichle for this change will be the new technologies, that will allow patients to be more educated in relation to their own health, as well as to save on bureaucracy and other red tape spending that now consumes the great majority of the available resources that, if saved would make a more efficient social model possible in Europe.
according to the European elites, especially the center-right ones it can’t and it must be reformed… they want to model Europe after the USA.. but there is another way.. I agree with them in some points, but to implement them, they must first stimulate growth and create jobs.. They do not do that, instead the follow Frau Merkel’s and Germany’s opinion on austerity.. So what they are saying is simply wrong… You can not end job and social security, if you first do not create more jobs so the people who lose their permanent jobs can be absorbed in the new ones created.. So until they understand that and start working on it, the European people will simply fight to secure the social and job security they fought for decades to achieve… for more please visit my blog at: http://eblanademocraticmove.blogspot.com/2012/04/economic-ideas-forum-my-opinion-on.html
“you can not end jobs end social security” sounds very reasonable, but social security is a product of employment end tax regulations, when there is no one working there is no social security. besides that nobody dies anymore. So you want to live longer than you have to earn it, the best remedy is forced bootcamp for the entire nation.
we should drag those fat bastards out of those factories and offices brake them first and rebuild them untill they get it, you cannot expect to smoke and drink and eat till your lungs look like a latrine and still cry for help like a baby.
Ozcan funny that you only took a part of the sentence, the one it suited you obviously… Read again please, and quote the FULL SENTENCE…!!
“You can not end job and social security, if you first do not create more jobs so the people who lose their permanent jobs can be absorbed in the new ones created.. ”
Now it makes more sence, doesn’t it…?? It is back to school for some…!!
Ozcan funny that you only took a part of the sentence, the one it suited you obviously? Read again please, and quote the FULL SENTENCE?!!
?You can not end job and social security, if you first do not create more jobs so the people who lose their permanent jobs can be absorbed in the new ones created.. ?
Now it makes more sence, doesn?t it???
That’s exactly the kind of questions we would like to ask :-)
The european social model is based on the principle of solidarity. Solidarity between the rich and the poors, the persons who are able to work and those who are not, the heatlhy and ills.
Is it good to have an affordable collective social insurance or an expensive (or not) private insurance dealing with you when you are ill, handicaped, not at work ?
Are social services more efficient in a profit organization ? or quite the contrary regarding their objecties ?
We have the project of a webdocumentary on this kind of issues.
We had a post on the eu social model (http://eusocialwebdoc.wordpress.com/2012/03/04/where-is-the-solidar-power/). Solidarity is very often be seen as assistance, could be considered as the possibility of freedom in a decommodified conception (see Esping Andersen).
In what kind of Europe we would like to live ? I think that the solidarity principle is a european treasure we should not throw in the garabage, even if reforms have to be done in some extent.