When it comes to health care in the European Union, power and responsibility rests with national governments. But that doesnt mean that there arent areas where Brussels can make important contributions. A survey by POLITICO in November ranked access to and affordability of health care as the No. 1 priority for the EUs health policymakers by 2024.
Over the course of the year, POLITICO will be conducting a series of symposiums, asking leading experts to weigh in on the health care priorities for the next European Commission. In this first installment, we asked five health care experts: What is your radical suggestion for how the EU can reduce the cost burden on national health systems?
Democratize health care
Jean-Pierre Thierry is medical adviser for the health and consumer NGO France Assos Santé, based in Paris.
Giving patients and consumers a voice would make an important contribution to tackling health care costs.
The EU should put in place a network of citizens juries on health, comprising representatives of patient organizations and an equal number of randomly selected people to tackle questions about the fair cost of treatments in every member country. These juries would cooperate with health assessment bodies to weigh the value of new treatments. They would raise the bar for real-life evidence on innovation, preventing money from being spent on treatments that arent yet proven and limiting the “hype curves” that have led to the explosion of costs around exciting but premature drugs or technologies.
Even the richest European countries are being confronted by the dire consequences of cost bubbles in health care. Brussels must help by enforcing EU antitrust laws in the pharma industry and blocking the repeated “evergreening” of patents on treatments.
A true démocratie sanitaire would push politicians to reassess the commoditization of public health — shifting productivity gains back into the health system, instead of permitting the distribution of large dividends to industry shareholders and payouts on overvalued biotech stocks.
Jayasree K. Iyer is executive director of the Access to Medicine Foundation, based in Amsterdam.
Health care systems are heavily burdened by the high price of medicines — and Europe is behind the curve in tackling the problem.
Setting up an EU-wide system for pooled procurement to buy medicines and vaccines in bulk, like the Pan American Health Organization already does for South American countries, could drastically reduce costs. Combining buying power would help payers in Europe purchase larger volumes at lower, more affordable prices and give them stronger negotiating leverage against the drugmakers that for now hold most of the cards.
This would be especially important for countries where the volume of patients may be small and thus struggle to negotiate low prices.
It would also suit the mosaic of socio-economic groups living in EU countries. Theres huge variety in the bloc in peoples abilities to pay. Its the responsibility of governments to ensure that medicines are available to all groups. Companies need to be encouraged to set prices according to the ability to pay, not on what some are willing to pay.
Menno Aarnout is former executive director of AIM, an international association of non-profit health care payers based in Brussels.
Brussels must constrain the ability of profit-driven health insurers to drive up prices.
With increasing budget constraints, some national governments leave the responsibility for aspects of health care coverage to private entities. Unfortunately, private for-profit insurers pick “good” risks and differentiate insurance premiums between young and old, healthy and unhealthy, leading to higher prices and limiting access to care.
Health care mutuals are private entities too but they are based on solidarity. They accept everybody as their members; they dont differentiate premiums and they dont have shareholders to please with profits.
The EU needs to use its insurance solvency rules, state aid laws and influence over tax policy to support solidarity-based health care mutuals over for-profit insurers. That includes facilitating legal recognition so that mutuals can work across borders. In some countries mutuals have existed for 200 years but in others, they never have.
By Reinier Schlatmann, CEO Philips Central Eastern Europe
Poland belongs to one of the fastest aging countries in the EU with cardiovascular diseases and cancers as the leading causes of death. With a relatively high level of unmet needs for medical care in combination with staff shortages, as well as a primary care system in need of further development to relieve hospitals, Poland is looking for solutions to address its most burning health care challenges.
Digital, connected technologies and health care informatics based on big data offer huge potential in simultaneously addressing the need for an improved patient experience, better health outcomes, an improved staff experience, and lower cost of care. Therefore, if I were to choose the one area where the EU could have the biggest impact, it would be through the role the EU could play in strengthening cooperation between member countries to develop economic models and infrastructure for digital, integrated care solutions, and reimbursement models that reward outcomes.
At the same time, it would be equally important to support digital transformational and connected care solutions with EU funds. Only by addressing both needs in parallel, will this bring meaningful and measurable results to Poland, enabling us as well as other EU countries to address the pressing challenges of todays health care.
Take a multi-faceted approach
Clemens Martin Auer is Austrias special envoy for health.
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