The prognosis is not good. Unless Europe’s healthcare systems change how they operate, there is a big question mark over how sustainable they really are. As Europe’s population ages, chronic diseases grow more widespread, and public spending fails to keep up with demand, healthcare systems are being asked to do more (and better) with less.

Europe’s ageing population is forecast to push up health and long-term care spending in the EU by up to 10% of GDP by 2060, according to the European Commission. Already there are signs that the various healthcare models employed by different EU Member States are struggling to cope.

We had a comment sent in by Mac, who wonders why the cost of healthcare systems keeps going up and up. According to the World Bank, public healthcare within the European Union was 12% of total government expenditure in 1995. That has risen to 16% in 2014. Is this trend likely to continue? And is it sustainable?

To get a response, we spoke to John Bowis, former British Conservative MP and MEP, and British Health & Social Services Minister (1993-1996). What would he say to Mac?

To Mac, I would say the current forecasts are that it’s not sustainable unless we do something different in terms of planning and initiating health policy. And the reason, of course, it’s not sustainable is the fact that people are living longer, and as they live longer they develop some very expensive neurodegenerative illnesses and so forth. We know that science moves on a pace, and that’s good news, but it brings ever-increasing costs in terms of drugs and devices and therapies, and that puts more and more pressure on public spending at a time when, as we know, there’s been a mood of austerity around Europe, trying to recover from the economic problems of recent years.

These pressures are going to go on. So, what do we do about? I believe we do need to spend more, but to do that we need to convince governments and the European Union that health is not just a cost, it’s an investment. Investing in good health, and investing in the recovery from poor health, is actually a contribution to economic growth because if you have sick people not only do they cost in terms of medicines and care and so forth but they’re not able to go out and earn money and pay taxes and so forth, so it’s a vicious circle. We need to get government’s understanding that they need to invest in health and then we get the rewards later.

I think we also need to see how the individual can play a bigger part in his or her own health management. It needs health literacy, and a concerted effort to recognise that patients are in fact experts in their own health, in the sense that they experience it directly, unlike any academic study. So, they should be partners with health professionals in managing their own health. If we manage that better, it can ultimately reduce costs…

We also had a comment from Rita, arguing that more public money should be invested in prevention. At the moment, roughly 3% of total healthcare budgets in Europe are being spent on prevention. Instead of spending more money on hospitals, doctors and pharmaceuticals, should we be investing more in public health campaigns, free exercise structures in parks, more bike lanes, etc?

To get a reaction, we put Rita’s comment to Ain Aaviksoo, Deputy Secretary General for E-services and Innovation at the Estonian Ministry of Social Affairs. Health spending as a share of GDP in Estonia is 6%, well below the average in the OECD (8.9%). The country has a mixed record on health outcomes in general, but it does perform very well in some areas (for example, it has among the best child health indicators in the OECD). So, what would Ain Aaviksoo say to Rita?

I would say to Rita that she’s exactly the kind of person we need to hear more from, to demand these kind of actions from policymakers. Believe it or not, one of the problems is that people tend to think about their health more only when they actually become sick. So, there is very clear demand to have services when people knock at the door of a doctor, and we also need to realise there is a very strong industry behind all of this health technology and pharmaceuticals.

We need a paradigm shift, but it won’t happen without very clear support from different stakeholder groups, including from citizens. I would say that the glass is perhaps not yet half-full, but it’s at least increasing… People like Rita can encourage change by talking to their friends and neighbours, because prevention only happens if people do their part. It’s easy to expect that a doctor will prescribe a pharmaceutical, you go and buy it, the government pays for it, and then you become healthy again. But when the doctor tells you that you need to go and run or ride a bike, nobody but that patient herself can actually take the bike and go and actually ride it. So, it’s a combination of a new kind of social contract between citizens and policymakers, but it starts with the demand from citizens that was so well expressed by Rita asking this kind of question.

Are European healthcare systems collapsing? Are some models more sustainable than others? Why aren’t policymakers investing more in disease prevention? Let us know your thoughts and comments in the form below and we’ll take them to policymakers and experts for their reactions!

IMAGE CREDITS: CC / Flickr – Hamza Butt
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75 comments Post a commentcomment

What do YOU think?

  1. Andrea Scacchi

    Another reason to secede from the EU.
    Public health, public school.
    Stop migrant invasion.
    Stop EU.

    • Andrea Scacchi

      Of course it doesn’t but eu policies are crippling public healthcare and education across the continent to leave room for business

    • Tit Dabeerlover

      It seems indeed, that this europe is just an american dream. Big money for firm/corrupt leader and less and less public services.

    • nikola

      ROFL, have you tried non-eu healthcare? Private health care leads to people with dog-tags “do not call ambulance” because the average price for being driven to the hospital is $600 to $1000 (just google “average price for ambulance”).

  2. Paul X

    Why when it says the increased pressure on the healthcare system is coming from an ever aging population do some people claim the solution is more “exercise structures in parks & more bike lanes”?…nobody doubts it can be good for you but I’ve yet to see the exercise structure that can reverse the effects of aging…

    • James McManama

      I think the point is that healthy older people are much less of a strain on healthcare systems than unhealthy older people, and that regular exercise and a good diet produces more of the former and less of the latter.

    • Paul X

      That may well be what is being suggested James, but I see it as two totally separate issues, people getting old and young people living a very unhealthy lifestyle, both contribute in different ways to pressure on healthcare.
      Generally, being unhealthy and getting old is not a common combination

  3. Lino Galveias

    yeah because of stupid conservatives wanting to turn into private and profitable systems
    migrant invasion has nothing to do. Many are also doctors, nurses, engineers, children, etc.
    Stop following the sheep!

    • Arnout Posthumus

      yea growingly elders aswel. So we kinda need migration.

      But the blame is on the babyboomers :d

  4. catherine benning

    Are European healthcare systems collapsing?

    The UK healthcare is free at the point of use. We do not have compulsory private health care it is paid for through National Insurance and comes directly out of your salary. It is called the NHS.

    When it was set up it was to take care of a population of under 55 million. However, mass immigration legal and illegal has increased our population to over 65 million, plus an amount of illegals that runs into the millions. All of them given free health care at the point of use. And government has not kept up with necessary additional funding or people to run it as it once was. Much of it is turning into third world service. Particularly in Obstetrics and Geriatrics. Immigrants breed prolifically and the children now born to non British born mothers far outweighs the indigenous population. Likewise, the elderly have doubled in number as so many have been brought into the country as ‘family’ members and those here from the 50’s on have aged with very many of them having never worked a day to pay for it. Simply being either stay at homers or benefit recipients.

    As a result our people are now waiting months to see a consultant when they have serious illness, or, cannot find a decent service to have their children as many midwives are from third world training and inexperienced in modern health care. Babies are dying at a rate unknown.since Victorian times. Filthy unacceptable conditions. If you are rich or have private health insurance you are somewhat better off, but, often not by much as those caring for you are inadequate.

    Example: A friend of mine was found in a top London tea\ching hospital to have a lump in her throat. It has ben since December last year she has been listed to have a biopsy etc.. Onlyy did she go for this exploration last week. And it is not until End of October she goes bak to find out what it is. The consultant is great, top in his field, however, the list is so long it is a waiting game. Imagine that from December 2016 until October 2017 for a large lump in her throat. Oh, and the first hospital denied it existed. An MRI scan has since shown it to be at least an 4.5 centimetre in diameter. So much for didn’t exist. Oh, and the ultra sound scan last week shows she had numerous lumps at least three in the thyroid.

    This is because the madman, Tony Blair, who is begging Juncker to give him a European role, as he opened the doors to millions of immigrants whilst he was in power at the EU behest. And of course decided to murder millions of others in Iraq to keep the idiot Bush happy.

    Although, now it is easy to see this was the plan being followed by Europe and its multicultural future Our infrastructure is literally falling apart and that includes our NHS. Which was never set up to be an International health service for billions in the third world. Or even millions from Eastern Europe. We have been mugged by politicians and they dare to call us names if we bark at all.

    The way the British are so tolerant is a joke. What has happened to us as a nation is an enigma. So yes, our health care is collapsing. Along with everything else in our once civilised country.

    • John

      And how is this immigrant’s fault? Right, right, you cannot blame yourselves so there’s always a solution to that. Pathetic!!!

    • Paul X

      @ John, stating facts isn’t the same as apportioning blame. The fact is that an aging population and high immigration is putting pressure on the NHS. Based on this there are only three options, taxpayers cough up a lot more money, you euthanise the aged, or you limit immigration…now which is your preferred solution?

  5. EU Reform- Proactive

    No takers?

    “Unless Europe’s healthcare systems change how they operate…………………..” Please, tell us HOW?

    Of course- scaremongering- to believe only the EU can fix all ills? Sweet talk, privatization, higher costs & increased state debt maybe?

    “In sum: in spite of national efforts to retain control over healthcare, such control is in fact steadily eroded. The result however is less the emergence of a unified EU policy than a complex system of partial overlapping national and EU competences that at various points both come into conflict and complement each other. Overall the net effect is an increasing impact of EU policies on healthcare even in what for the foreseeable future will be the absence of an EU policy on health.”

    • Fred Lindén

      Great Debate, and I love all the effort the Portuguese put into the eHealth network. I hope Swedes spend enormous amounts of money in the Silvereconomy in Portugal. But I would like to introduce “your favourite write checking tool” e.g. Grammarly to the EC “We know that science moves on a pace” (should it be “at pace” and further down “but it does perform very …..”

    • Pepijn Warmerdam

      Socialism has done a lot too raise the the general standard of living for a lot of people in Europe. It works.
      And if narcotics didn’t work people would not use them.

    • Sebastian Lavender

      Pepijn Warmerdam well it not working. People in Europe have their way of life, thanks to 70% of the world working for 2$ a day.
      That is the truth. We have our electronic gadgets, cheap clothes, a lot of cheap food, thanks to hardworking people mining minerals bare hands in Africa. Get used to it.

    • Tit Dabeerlover

      Sebastian Lavender Nope, we could have same lifestyle even better if custom taxes still exist. That is how you deal with social dumping. But big firm just want you to be poor. Get used to it.

    • Paul X

      “Socialism is like narcotic drugs” yes, expensive for those who work for a living and abused by those who don’t

  6. Jaime Manca Graziadei

    The question is not whether the programmes are good or not, the question is how much do they cost and could they cost less and work better for the patients and ONLY the patients.

  7. Richard

    If European countries are going to offer such generous health schemes – it makes sense that they regulate people’s environments in order to make them as healthy as possible. Banning coal, banning petrol/diesel-fueled cars, banning sugar, promoting green open spaces and walking/cycling are all sensible moves.

    Finally the amount spent on the elderly needs to be reduced, and euthanasia encouraged.

    Otherwise I fear we risk a ‘death spiral’ where the taxes on young workers (already very high) increase to the point where they are unable to have children or themselves emigrate completely. We could use land and wealth taxes to charge rich elderly for the services they are receiving.

  8. Elisabetta

    We need more interventions on primary care and prevention, healthy environment, disease and care management, we need more awareness of the implications of degenerative and chronic illnesses, patient and their families need more social help and self empowerment.
    Nowadays, our heath systems are still focused on hospitals, giving care and acute medical treatment. We do very little to prevent illness (prevention, education, promotion of healthy life styles….) and prevent / reduce chronicity.

  9. Carl Glover

    Ofcourse they are, the EU(SSR) has inundated them with non contributing, parasitic, third world and islamic economic migrants on mass, simple.

  10. Wojciech Małecki

    In Poland it has collapsed ages ago. Now it can only get better. With western europe it’s rather time for collapse. It drains wallets too uch.

    • Rémi Martin

      “Now it can only get better.” Sure, with all the money form EU… It doesn’t come from a hat you know. ^_^

    • Wojciech Małecki

      Rémi Martin Money from Poland not EU. We pay more than get from EU. We’ll get back true socialism not binladen breeding as you demand from us. And then every Pole will have premium level med-care as they deserve by birthright.

  11. Paul X

    If the EU had as much enthusiasm for creating some form of pan European health care, then they do for creating an EU Army, then god forbid, they may actually be credited with doing something useful

  12. Maia Alexandrova

    The majority of health problems come from eating bad food which over the years slowly destroys the body from within and makes people ill. When more people have diseases, there will be an increased pressure on the healthcare systems. For the past years statistics have showed a dramatic increase in all kinds of diseases and particularly type 2 diabetes and heart attacks – conditions directly related to what we eat. Yet there is very little attention paid to how food can be used to prevent and heal diseases. There is no need to pay for expensive drugs and chemical treatments with damaging side effects. There are new (old) ways of natural treatment being practised already by many people around the world and with amazing results, using some unexpected “magic” pills – raw fruits and vegetables, or even just water. There is information by doctors and scientists, medical studies that prove the remarkable healing properties of raw plant foods, especially when they are combined with hunger for a limited period of 1-3 weeks. This triggers detoxification and activates the self-healing processes in our body and amazing results follow after just one or several courses of the treatment – cured diabetes (type 2), blood pressure normalised, depression disappeared, as do chronic headaches, infertility, diseases of the digestive system. It also prevents dementia and diseases linked to old age. We need doctors to be able to use this kind of therapy routinely on every patient who wishes to have it, not to be bombarded with chemicals at the first opportunity, with doubtful results in the end. Unfortunately, it is all about the lack of interest by the governments and maintaining the pharmaceutical industry alive and prospering. If prevention and cure of diseases was by natural means, then gradually less and less people would need doctors, hospitals and harmful medicines which means healthcare systems would not be collapsing. I think the only way to save healthcare would be for nations to become healthier. The main medicine for that is food. This is not simply about healthy eating, but about permanently saving our lives from disease and achieving true happiness. It is possible.

    • Tarquin Farquhar

      @Maia Alexandrova
      Some very interesting AND accurate points.

    • José Bessa da Silva

      Our system is collapsing because of the EU and it’s “austerity”. Don’t lie.

  13. ironworker

    Big Pharma Industry will. Hopefully, there are a few patriots opposing the big takeover. All healthcare systems should be nationalized and/or militarized as national security objectives.

  14. Bódis Kata

    The UK needs to train enough own doctors, but it attracts doctors from everywhere else instead. It’s like the big black hole of European medicine.

  15. Andrea Brown

    Firstly the Conservative MEP you quoted is a member of a political party hell bent on privatisation of all health services regardless of how good they are. Secondly prevention such as mandatory HPV, flu, etc vaccinations combined with dietary and lifestyle advice will help reduce the costs and allow money to be targetted better. The constant privatisation of various sections of healthcare needs to stop and hospitals need to start integrating better with medical teaching.

  16. Frankie Perussault

    I dare not speak up my mind here. Can I say that prevention and protection is the CAUSE of the problem, without being lynched? We, human creatures, are regarded as a mob that public health (how health is public?!) has to keep “treated” with all sorts of medication. Darwin must turn in his grave! Survival of the fittest, he said! The fittest is the one who survives against all odds with his/her own capacity to resist illnesses. I DO NOT mean to let everybody else die in the street but I mean to say we are overall too much protected, too much prevented from tackling our own health.

    • Spyros Kouvoussis

      he didn’t say that this SHOULD be the way a society is run, but how it happens in nature.

    • Frankie Perussault

      …well, it doesn’t happen in nature anymore! and if we keep going the way to “protect” and “prevent”, we might not be able to adapt to and face the future. Just my opinion, mind you.

  17. Doru Beldiman

    In Romania is in collapse for 28 years! So, don’t blame those Romanians who are emigrating, they can’t can’t live in this country robbed by those in Government, in Parliament, by politicians and their accomplices! Europe should push hard the Romanian politicians!

  18. Andrew Potts

    Under strain and probably need better management, goals and requirements rather then bottomless pit wish lists.

  19. Gajdos György

    The retirement age should be pushed higher. When retirement was first invented the health of people was actually much worse at elderly age. Today most 60somethings are very well of and most of them happily looking for some work.

  20. Anatilde Alves

    Not really, but that really depends on wich countries in Europe we are talking about, coz it’s not the same everywhere. I’d say central Europe does fine on healthcare.

  21. Christos Boras

    After the fall of the Iron Curtain , money vanished and every sense of welfare state and of the social contract is collapsing….. Merely a coincidence….

  22. Craig Willy

    Yes, if public opinion and statesmen had had a greater sense of Europe’s common civilizational interests, and of how fragile power back then really was.

    • Craig Willy

      The same for World War II, by the way! Some tried to warn us!

    • David Haston

      Looking forward to a good chat in June of you have the time.

  23. David Haston

    ‘Privatisaton’of th NHS started under Prime Minister Blair and continued under Prime Minister Brown.

  24. eusebio manuel vestias vestias

    I advocate a single health system in the State of the Union Costs will rise exponentially and will stress the service even more as the ageing population closes in on the carrying capacity of the economy Funding though need not be a major cause for concern The monetary Government can pick up the tab for whatever the endeavour costs If it wants a partial solution a private system can run alongside the public

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