EU must 'take more initiative' on health inequalities

Policymakers and economists must stop looking at healthcare only as an expenditure, writes Biljana Borzan.

By Biljana Borzan

05 Oct 2014

When speaking about healthcare, the first thing that comes to mind is that it is a system organised separately by member states and that the European Union doesn't have much of a say in these matters. Member states indeed have the right to run their healthcare systems as they see fit, but some important matters surpass national borders.

In all the founding documents of the EU we find a strong commitment to solidarity, social and economic cohesion, and equal opportunities for all. This is especially important relating to the fact that there are large discrepancies between member states when it comes to the quality and accessibility of healthcare services. It is my strong belief that all decision makers in the EU should actively contribute to minimising those discrepancies.

"It is now clear that lesser quality in healthcare services has resulted in losses that have offset the temporary fiscal benefits of budget cuts"

There are several programmes whose goal is to equal the chances of survival of new-born babies or lengthen the average life expectancy for all EU citizens. Unfortunately, despite such worthy efforts, the long-lasting economic crisis has negated most of their positive effects. A crisis-driven austerity has resulted in healthcare budget cuts in many member states. In the short term this seemed like the right thing to do, but in the long term there was a price to pay. It is now clear that lesser quality in healthcare services has resulted in losses that have offset the temporary fiscal benefits of budget cuts.

If you ask me, health has no price tag. When thinking about which therapy to administer or which diagnostic to run on a patient I seldom regarded the ensuing costs. That probably makes an economist cringe, but I am aware that doctors cannot go on a spending-spree in the name of health. The problem is that healthcare is viewed only as an expenditure, without taking in account all the benefits of a healthy society. When administering cuts governments neglect the fact that the improvement of public health is proportional to economic growth and vice versa. The key punchline here is 'health pays', as it summarises the truth about health and healthcare. It pays for the individual who is healthy and content, it pays for the healthcare professional who is actively contributing with their skills and, in the long term, it pays for the economist as well.

Many challenges lie ahead as the 21st century brings new health related issues. Increased prevalence of chronic non-communicable diseases, an increase in various addictions among the youth, obesity and all of their negative consequences are some of these challenges. Furthermore, an increasingly deteriorating demographic context is stretching the sustainability of our healthcare systems. We shouldn't bury our heads in the sand and talk about subsidiarity and national prerogatives. The rises in obesity among children or dementia among seniors are not affecting only Germany, Poland or France. Another example where joint action is necessary is the treatment of rare diseases. These problems are affecting all member states and as such they should be tackled by sharing best practices and information, as joint action will increase our individual chances of success. When faced with a lack of human and financial resources at national level, we should strive to create and use tools and mechanisms at the EU level.

"When faced with a lack of human and financial resources at national level, we should strive to create and use tools and mechanisms at the EU level"

A good example of a successful joint action is the tobacco products directive. It was envisioned as an answer to the problem of more and more young people smoking and the result was a union-wide clampdown on tobacco industry's marketing and targeting practices. All our citizens should enjoy a similar level of healthcare quality and accessibility. I hope that in the future we will see the EU institutions take more initiative on tackling health inequalities by coordinated action at union level. When it comes to legislative priorities, I believe that by the end of the Italian presidency we should have finished with the directives on medical and in vitro devices. Existing laws are inefficient and the scandals with faulty breast implants and hips have shown that the citizens are paying the price. Furthermore, the directive relating to the transparency of measures regulating the prices of medicinal products is a vital piece of legislation as well. It should be prioritised as, once in place, it will benefit competition, research and development.

To conclude, 'health pays' should highlight another dimension of European healthcare – that investing in prevention is always cheaper than spending on treatment. A prevention-centred approach will, in the long term, result in a cheaper, better, more accessible healthcare and a healthier European society. And that is something doctors, managers, economists and, most importantly, patients can agree upon.

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