Abstract
Health expenditure is a particularly sensitive political issue for European Union countries. This is due to the continuing increase in expenditure, the considerable state spending devoted to this field and the questions that are raised on the effectiveness of this state spending. However, going beyond these general factors, there are significant disparities between the situations in the various countries. These reveal differences in the quality of the services provided and costs of these services. These differences may help to understand not only certain disparities in the economic attraction of the countries but also the geographical mobility of patients seeking healthcare. To explain the background in which European health systems operate, this report gives a few introductory remarks on the methodological choices, followed by an overall view of the situation regarding healthcare expenditure, indicating the current trends. The next section comments on the quality of the results obtained given the reimbursement rates provided for the public and the health situation as it stands. Finally, the report comments on the regulatory mechanisms that have been adopted to ensure better use of resources.
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Notes
- 1.
For dental care, a ceramic crown (for which there is no set tariff) is half the price in Germany than in France where a large part of the cost is borne by complementary health insurance.
- 2.
System of Health Accounts (SHA).
- 3.
Calculated as purchasing power parity (ppp) to take account of differences in the cost of living between countries.
- 4.
In the United Kingdom, the WANLESS report on “Securing our Future Health”, published in 2002, considered that the country was not investing sufficiently in healthcare and proposed a series of recommendations to increase total health expenditure to 10 % of GDP.
- 5.
Unlike the cure approach, which covers all medical treatment used to cure disease and health problems, the care approach covers all that is related to prevention as well as support for and the attention paid to patients.
- 6.
Such as allergies, diabetes and high blood pressure.
- 7.
These three points were covered in detail in the first report by the Haut Conseil pour l’Avenir de l’Assurance Maladie in 2004.
- 8.
These do not release subscribers from the obligation of contributing to finance the public system.
- 9.
In this context this is “allocative efficiency”.
- 10.
On the political front, poor use of resources can also result in a loss of confidence in state action and reduce willingness to pay taxes.
- 11.
In 2010, Estonia and the Czech Republic were ranked 18th and 16th for life expectancy in the set of 21 European countries considered.
- 12.
This concern with regulation is relatively long-established in Germany as Germany was one of the first European countries to implement a global health expenditure control policy. The Advisory Council for the Concerted Action in Health Care was set up for this purpose in 1977, bringing together all those involved in health.
- 13.
Evaluated according to life expectancy.
- 14.
It is known, for example; that housing, education and environment policies have a direct effect on public health.
- 15.
The obstacles encountered in developing and financing the care related to dependency are a good illustration of these difficulties.
- 16.
The private sector, which is present to some extent in all countries, falls naturally into this system.
- 17.
The effectiveness of medical protocols remains however conditioned to a considerable extent by the way in which the information is made available to the medical corps and by the scope for independence that is left in the recommendations.
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André, JM. (2014). Health Expenditure in the European Economy. In: Hennion, S., Kaufmann, O. (eds) Unionsbürgerschaft und Patientenfreizügigkeit Citoyenneté Européenne et Libre Circulation des Patients EU Citizenship and Free Movement of Patients. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41311-7_11
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