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    European health systems could be in better health

    © European Union, 2018 Photo: Lukasz Kobus
    Vytenis Andriukaitis, Commissioner for Health and Food Safety
    © European Union, 2018 Photo: Lukasz Kobus

    A recent joint report of the European Commission and OECD shows that health spending in EU accounted for 9.6 % of GDP in 2017 but that one-fifth of spending is wasteful because of unnecessary tests or treatments and that 1 200 000 deaths could have been avoided through more effective and timely health care. The 2018 Health at a Glance: Europe presents comparative analyses of the health status of EU citizens and the performance of the health systems of all EU Member States, 5 candidate countries and 3 EFTA countries. It is the second report since 2016 when the Commission launched a two-year cycle of reporting to assist Member States in improving their health system.

    “While the life expectancy in the EU is among the highest in the world, we shouldn’t rest on our laurels,” said Vytenis Andriukaitis, Commissioner for Health and Food Safety, at a press briefing on 22 November. “Many lives could be saved by increasing our efforts to promote healthy lifestyles and tackle risk factors such as tobacco or lack of physical activity.”

    The report draws the intention to a number of health issues. Mental health is a critical area and needs to be given more priority. Mental health problems, such as depression, anxiety and alcohol or drug abuses, affect more than one of six people across the EU. In 2015, the deaths of 84 000 people were attributed to mental illness or suicide.

    The total costs of mental ill-health are estimated at more than 4% of GDP – or over EUR 600 billion – across all EU countries.

    The report puts also a greater focus on preventing risk factors, such as smoking, alcohol and obesity. While smoking rates in both children and adults have declined in most EU countries, about one-fifth of adults still smoke every day.

    Alcohol control policies have reduced overall alcohol consumption in several countries but heavy alcohol consumption among adolescents and adults remains an important public health issue. In EU countries, nearly 40% of adolescents report at least one ‘binge drinking’ event in the preceding month.

    The prevalence of obesity continues to increase among adults in most EU countries, with at least one in six defined as obese. Inequality in obesity remains marked: 20% of adults with a lower education level are obese compared with 12% of those with a higher education.

    It is estimated that 790 000 people in EU countries died prematurely in 2016 due to tobacco smoking, harmful consumption of alcohol, unhealthy diets and lack of physical activity.

    Vaccine-preventable diseases have resurged in some parts of Europe in recent years, pointing to the importance of promoting effective vaccination coverage for all children across all EU countries.

    “It’s not for politicians but for physicians and experts to decide whether vaccination should be mandatory or compulsory,” said Commissioner Andriukaitis, himself a medical doctor and surgeon from Lithuania. “The aim is to reach a high coverage and for parents to take their responsibility.”

    Unmet health care needs are generally low in EU countries, but low-income households are five times more likely to report unmet needs than high-income households, says the report. Long waiting times for elective surgery is an important policy issue in many EU countries as it impedes timely access to care.

    Asked by the Brussels Times if the imbalances in the European health systems could be addressed by cooperation between national health systems and receiving medical care in another EU country, the Commissioner referred to the EU cross-border health directive (2011/24) on the right for EU citizens to access healthcare in any EU country and to be reimbursed for care abroad by their home country.

    “It’s time to raise awareness about this directive and to further develop it,” he replied. According to a Eurobarometer only 17 % of EU nationals feel well informed about health care reimbursement in another EU country. The directive entered into force in 2013 but was followed by a high number of infringement procedures.

    A Commission report (September 2018) to the European Parliament and the Council states that cross-border patient flows are showing a stable pattern, mostly driven by geographical or cultural proximity. In 2016, only approximately €65 million or 0.004% of the EU-wide annual healthcare budget was spent on cross-border healthcare.

    M.Apelblat
    The Brussels Times