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17 March 2011
Health First Europe attended the launch of “Health Care Reforms in an Ageing European Society” which looked specifically at the burden of cost on European healthcare systems as the population ages. The study was undertaken by the Centre for European Studies – the official think tank of the European People’s Party (EPP) - in order to determine a health system of best practice which could potentially be utilised for benchmarking. As one of the few systems which has successfully transitioned from a publicly financed system to one of competitive services, the publication and the participants in the conference focused on the reforms undertaken by the Netherlands.
Deputy Director of the Research Institute for the CDA, Dr. Evert Jan van Asselt, explained that the Netherlands was used as the focal point of the study due to its estimated long-term health care expenditures which in 2010 are 3.5 percent of GDP – almost double that of any other Member State (expect Sweden). By 2060, it is estimated that the Netherlands will spend more than 4.5 percent of GDP on health care whereas other European countries will average just 1.3 percent.
In 2006, the Netherlands began implementing curative health care reforms which included changing to a private insurance system with public guarantees. The insurance companies compete for the insured on cost, service and quality of care and are free to negotiate with hospitals on price and diagnosis treatment combinations. This system has allowed for greater efficiency, however, reimbursements are still made based on quantity of care rather than quality – an issue that continues to hamper the effectiveness of the current reforms.
Following the presentation on the report, Dr. Reinhard Busse, professor for Management in Health Care at the Technical University of Berlin and Associate Head of Research policy of the European Observatory on Health Systems and Policies, asked the question, “Do we live longer because we are healthier? Or are our extra years plagued by disease and co-morbidity?” He clarified that there is no clear correlation between health expenditure and ageing but argued that systems must disentangle disease from costs as many of the costs incurred for older persons are tied to health maintenance rather than disease (i.e. hip replacements). He further challenged policymakers to see health care as more than financing and to address challenges through the use of health technology assessment (HTA), attention on prevention, integrated care across providers/diseases and through the use of e-Health.
As the final presenter, former Dutch Minister of Health Care and Sport Dr. Ab Klink offered his opinion on how other Member States can learn from the Dutch experience with regards to health care reforms. He suggested that rather than looking to lessen costs through cost containment or rationing of care, the ultimate goal should be for reimbursement systems to change from paying for quantity of care to paying for quality of care. He declared that efficiency in care can also reduce cost and cited the study conducted by John Hopkins University as showing that by reducing health care associated infections (HAIs), its hospital was able to save $50 million. Dr. Klink continuously emphasized that value-based health care is the only means to ensuring sustainable European health care systems as the population ages.