All this week, Debating Europe will be publishing a themed series of posts looking at the issue of health and wellness in Europe. With healthcare budgets increasingly coming under pressure, it’s important to look at ways to maintain public health without breaking the bank. Our previous post in this series looked at the problem of obesity in Europe, and today we’ll be looking at ways to encourage a greater focus on prevention instead of crisis-management.

In one of our earlier debates on the future of healthcare in Europe, we had a comment sent in from David that painted a particularly bleak picture:

I am pessimistic about the future of EU healthcare. Doctors’ offices will overflow as populations age, with less time for proper diagnoses, while writing prescriptions for pharmaceuticals will be the easiest solution to ease the backlogs. So we will have more pharmaceuticals covering up early diagnoses until crises turn individuals into patients in the medical system.

We took this comment to Michèle Rivasi, an MEP from France who sits in the Greens–European Free Alliance group in the European Parliament, for her to responsd.

Is it too late to avoid the rather bleak scenario that David paints in his comment? Or could better public health be achieved for cheaper if there was more of a focus on healthy living, regular excerise and balanced diets? We had a comment along these lines sent in from Peter, arguing that:

We all by now see the benefit of moving from a focus on disease care to maintaining health and wellness. Now we have to design a new model with a new role for the health care sector, one that moves beyond saving lives in a crisis…

But if everybody already accepts the benefits of such an approach, why hasn’t it happened yet? To get a response to this question, we spoke to Walter Ricciardi, President of the European Public Health Association (EUPHA), an umbrella organisation for public health associations and institutes in Europe.

ricciardi-speaksPeter is absolutely right, and this is happening because the care in health services is doctor-centred rather than patient-centered. This means that doctors have been trained to wait until patients are sick, and wait until they come to hospitals to seek treatment. And this model is, with the increase in life-expectancy, not affordable anymore; now that we regularly have patients who are 80 or 90 years old with multitple diseases, this is unsustainable. Even the richest countries in the world cannot afford this.

To get another perspective, we also put Peter’s comment to Andrzej Jan Rys, the Director of Health Systems and Products at the European Commission. Why haven’t European countries moved towards a focus on prevention yet?

rys-speaksI think we are still in a transition period. On the one hand, we know already that prevention works. On the other hand, we also know that it’s very difficult to introduce this concept into daily life and into health systems without appearing to interfere in people’s private lives. There is a difficult public debate about the role that the state and local government can play here; there is, of course, the famous idea of the ‘nanny state’ telling its citizens how to live their lives.

There are some parallels with public health debates in the past. In the 18th and 19th centuries, when doctors started promoting the importance of public hygiene, including clean water, sanitation and sewage systems, it was a revolution. In the 21st century, we are in a similar situation, except instead of hygiene and sanitation we are talking about alcohol consumption, smoking, diet, physical exercise, etc.

At the moment, less than 3% of total healthcare budgets in Europe are being spent on prevention, and the big question is how and where we should be spending money in order to encourage a greater focus on prevention, which would ultimately save us money in the long-run.

We also had a response to Peter’s comment from John F. Ryan, acting Director of Public Health at the European Commission, who warned that governments shouldn’t automatically go for the ‘low-hanging fruit’ of health promotion campaigns if they are cutting healthcare budgets.

ryan-speaksIf countries are undergoing financial difficulties, prevention activities can seem like a very low-hanging fruit. It might be tempting to cut back on health promotion campaigns rather than, for example, closing an emergency ward in a hospital. These are tough choices, but from the perspective of the Commission, we think this approach is likely to lead to a much greater long-term burden on the population.

Finally, we spoke to Richard Seeber, an Austrian MEP with the centre-right European People’s Party group and a member of the Committee on the Environment, Public Health and Food Safety in the European Parliament. He made the important point that healthcare is largely a national competence, though there are still areas where the EU can play an important role.

What do YOU think? Is it possible to promote better diets, regular exercise and healthy living without ‘nannying’ people and intruding into their personal lives? At the moment, less than 3% of total healthcare budgets in Europe are being spent on promoting healthier lifestyles. Is this enough, or would healthier living save us money in the long-term? Let us know your thoughts and comments in the form below, and we’ll take them to policy-makers and experts for their response.

21 comments Post a commentcomment

  1. avatar
    Limbidis Adrian

    This isn’t about “people living too long”, it’s about an economic system that no longer works for the reality on the ground. An economic system that considers people “live too long” and puts “profits” before people’s health is no longer serving us.
    Will we limit people lives so that the economic system works? Mandatory DEATH ?
    What happens in 20-30 years when the lifespan may reach 100+ years as standard?
    We will have “mandatory death” ? Executions so that the economic system keeps on going?

    This is insane, the economic system no longer serves us. It has ALREADY failed the world big time and nearly destroyed us all.
    It has served us until now. No more.
    Time for a change and if don’t do it, the ones in charge who benefit from it surely won’t.

  2. avatar
    eusebio manuel vestias pecurto

    Em algumas cidades da Europa ainda não desenvolveram projectos sustntabilidade e os seus habitantes não têm condições para praticar desporto e os politicos fecham os olhos os servidores publicos do poder local e as populações devem debater assuntos da cidade porque é necessária para o bom desenvolvimento da cidade porque a sustentabilidade na estratégica urbanistica de crescimento com condições de vida são favoráveis ao estilos de vida saudáveis

  3. avatar
    Efrossiny Exarchoulakou

    we should first evaluate the healthier style for every person because every person isunique and decide which health style representing the more

  4. avatar
    catherine benning

    @Debating Europe:

    Why have you removed the reply button from all the threads?

    Debate is proposal and response. You cannot have a debate without the right of reply.

    Censorship is a strange by product of an undemocratic society. Debate is the heart of democracy. Why have you been allowed to eliminate the facility to respond directly?

    Can you not see this is akin to a fascist regime?

  5. avatar
    Debating Europe

    Hi Catherine,

    We’ve temporarily removed threaded replies because the nested comments in some topics (particularly those topics with over 50 comments) were causing some display problems. You can still reply to other users by indicating who you want to reply to in your comment.

    However, if people miss this feature then we will try to fix it and bring it back. We have a big update coming very soon (i.e. in the next couple of days) and we can try to add this feature back in after that.

    P.S. Removing threaded commenting from a forum hardly makes us a fascist regime!

  6. avatar
    Rita Seara

    free exercise structures on parks, more trees, less meat, more community gardens, more bike lanes, free bikes, less cars (…)

    12/09/2017 Ain Aaviksoo, Deputy Secretary General for E-services and Innovation at the Estonian Ministry of Social Affairs, has responded to this comment.

  7. avatar
    Anabela Mesquita

    …Ama a Natureza e o teu proximo, para que caminhes livre puro e consciente do bem para o caminho da Luz, para o principio do “fim”!

  8. avatar
    Albert Saxén

    Obviously it wld. !!
    Think of all the benefts from the employer’s perspective, already :p less time away from work, etc.

  9. avatar
    Calin Petrut

    We should learn the kids to practice sports and to popularize the benefits with the help of school!

  10. avatar

    government should do absolutely nothing. let people decide what they eat, and how they live thier private lives.

    Here qre some ideas that could work:
    – Let airlines charge per kilo of the passenger, just as they charge for cargo
    – Allow higher insurance premiums for people that drink
    – Stop providing free medical care. If people paid to visit the doctor (not emergency care), then they might think more about health. In developing countries; poor people brush thier teeth, because dentist is expensive.
    – Legalise dance drugs like ecstasy, so as to reduce drinking and related obesity at night clubs

  11. avatar

    Ending free doctors would also significantly reduce the deficit, as well as actually improving health

  12. avatar
    Alexandru Ciupitu

    How can we encourage healthier lifestyles?


  13. avatar
    Angela Argentino

    It would BUT how is it possible if the trend goes opposite? Coca Cola ,soft drinks,fast food,junk food all are the ennemies of a healthier lifestyles .Teenagers don’t ever know the food sources not to speak about how to cook a meal that meets diet balance parameters …

  14. avatar
    angela argentino

    Dobbiamo insegnare agli adolescenti a cucinare ,a scegliere il cibo ,a capire l’importanza di una dieta equilibrata .Ma sono molto pessimista su questo perche’ gli interessi economici vanno in direzione opposta e quindi bibite piene di zucchero,cibo-spazzatura ,poco movimento . Se si dessero piu’ incentici al settore primario quindi all’agricoltura molti giovani senza lavoro potrebbero rimanere legati alla terra e da li’, il passo verso una sensibilita’ nuova sul valore di una alimentazione sana ,sarebbe piu’ breve .

  15. avatar
    Limbidis Adrian

    “Stop providing free medical care. If people paid to visit the doctor (not emergency care), then they might think more about health. In developing countries; poor people brush thier teeth, because dentist is expensive.”

    Nice try you little weasel but socialized healthcare is there for EVERYONE, in Europe it’s a RIGHT. you can’t come in and say “oh let the people decide themselves” because that will translate into:
    POOR people who cannot AFFORD to go to a doctor will DIE and the rich will be better off.
    Most likely you’re a person who mourned Thatcher’s dead not danced on it.

  16. avatar
    Paul X

    Well you made me chuckle with this one matthew

    “Legalise dance drugs like ecstasy, so as to reduce drinking and related obesity at night clubs”

    I fail to see how skinny junkies are any healthier than fat drunkards?

  17. avatar
    Carolina Neto Henriques

    To me, healthier lifestyles come today as stress-free. With all this crisis going on, nobody can rest truly, working out to get rid of stress, read a book, play with their children. Also, the ridiculous raise of taxes include raise on hospital fares, even if it was ‘free’ it is no longer. We have to pay, always, to do anything. At least in some of the countries in Europe. What grinds my gears is that if we are all from European Union, why are some countries different than others? Why do we (Portugal) have different salaries, different rules, no work, no play? Only because of our corrupt politicians? What about Europe’s other corrupt politicians? My government isn’t making nasty deals only for themselves. They’re giving Europe’s banks the chance to make big money out of Portuguese people’s misery, lack of access to health, to education. Having a better and healthier lifestyle to me starts with clearing the rules, cleaning corrupt politics and giving people the opportunity to enjoy their lives without worrying that their government wants to kill them slowly. Want to encourage healthier lifestyles? Let Europeans be healthy.

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