Healthcare under pressure as we live longer

Series Title
Series Details Vol.11, No.10, 17.3.05
Publication Date 17/03/2005
Content Type

Date: 17/03/05

Despite its limited responsibility for healthcare, the EU has sought to make reform of healthcare systems an integral part of the Lisbon Agenda. At Lisbon itself, healthcare reform was mentioned as part of a plan to modernise social protection systems.

In subsequent European Councils there has been a growing emphasis on the need to balance a quality of care commensurate with the standards of the European social model against the increasing pressures that providing such care places on government finances. The European Commission's 2004 communication, 'Delivering Lisbon', made clear that the need to "make use of more structured and formal co-ordination" in the healthcare sector was a priority.

In some ways, the EU's healthcare systems are victims of their own success. The Commission points out that, although it respects the member states' right to develop their own healthcare systems, nevertheless "certain problems are common to all the systems".

Foremost among these is the spectre that looms over the whole Lisbon Agenda - ageing populations. Thanks to advances in diet and healthcare, life expectancy is increasing across the EU. As a result, the number of people with age-related illnesses and in long-term care will increase. If, as predicted by Eurostat, there are 38 million people above the age of 80 in 2050, compared to 14.8 million today, it is unreasonable to expect that the amount spent on caring for them will not rise too.

The situation is complicated, as the French were appalled to discover during the heatwave of 2003, because an increasing number of old people are living alone. In addition, an increasing number of women, traditionally the main providers of informal care, are entering the labour market. Member states are well aware of the likely increases in public spending that will be demanded. A report by the Economic Policy Committee, which advises the Council of Ministers on structural issues, has estimated that expenditure on healthcare and long-term care as a percentage of gross domestic product will increase by 2.7% in 2000-50. But these estimates are viewed as rather conservative by member states.

With the accession of the ten new member states, who have largely struggled to reform and modernise their healthcare systems in recent years, the Commission argues that there is now an acute need to share best practice and develop a "coherent framework for catching up". As Philippe Brunet, a member of Health Commissioner Markos Kyprianou's cabinet, pointed out at the Euro Health Forum in 2004, the limited competence of the Commission may actually be an advantage in this respect. It could, he said, "foster the harmonisation of national healthcare systems by acting as a promoter of new ideas, as an honest broker vis-à-vis the member states". There have been some small successes, such as the European health insurance card and the Commission is desperate to pull the member states towards further reform.

Despite its limited responsibility for healthcare, the EU has sought to make reform of healthcare systems an integral part of the Lisbon Agenda. At Lisbon itself, healthcare reform was mentioned as part of a plan to modernise social protection systems.

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Related Links
European Commission: COM(2004) 29, Delivering Lisbon: Reforms for the Enlarged Union, 20.2.2004 http://eur-lex.europa.eu/LexUriServ/site/en/com/2004/com2004_0029en02.pdf

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