Healthcare in the EU: three independent expert opinions – what’s in it for patients?

How to effectively invest in health? How do we evaluate and monitor access to healthcare? How should we organise innovative payment models for high-cost innovative medicines? And how can we assess the performance of primary care?

Health inequalities carry a significant economic, societal as well as personal cost. EPF echoes the important inequalities and inequities experienced between and within Member States. EPF’s 2016 survey on access to healthcare (among other sources) demonstrates that health inequalities within and between EU countries are increasing.

Research provides evidence of the systematic failure of European health systems for many people currently living within the European region, particularly people in situations of precarity, social isolation or vulnerability.For EPF, providing access to healthcare for those most disadvantaged, who are currently not getting access to quality healthcare, and falling through the net, is a priority.

Reducing health inequalities is crucial for the overall health, wealth and cohesion of society. In all countries, life expectancy is strongly influenced by social determinants, including factors such as employment, income, housing, length of education and ethnicity. In addition, factors that create health-related vulnerabilities include poor working and living conditions, precarious or irregular residence status, and exposure to violence or discrimination.

The European Commission has asked an Expert Panel, made of independent scientists, to analyse evidence that could support the EU countries in delivering high quality care and making their health systems more effective, accessible and resilient.

On Friday 9 February they published three Opinions:

• Opinion on Innovative payment models for high-cost innovative medicines
• Opinion on Benchmarking access to healthcare in the EU
• Opinion on Tools and methodologies for assessing the performance of primary care

The Expert Panel organised hearings on each of the topics towards the end of last year, welcoming feedback from stakeholders, which was a welcomed improvement to the opinion development process. 

In the framework of the follow up of the 2017 campaign on Access to Healthcare, we had a look at the “Opinion on Benchmarking access to healthcare in the EU” more in detail.

The opinion looks at benchmarking access to healthcare in the EU. It proposes quantitative and qualitative benchmarks on access to healthcare. Finally, it discusses the possible use of EU funds and/or other mechanisms to support the improvement of access to healthcare according to the benchmarks proposed.

Some key takeaways can be highlighted from the document:

Additional data collection needed. Member States have recognised the crucial role of strengthened data collection and capacity-building and committed to addressing the data gap, and where possible, monitoring should be based on comparable and standardised national data obtained through well-established reporting mechanisms.

A useful set of indicators. The opinion details a number of relevant indicators, such as unmet need, affordability, availability and accessibility, user experience and inequalities and inequities but at the same time it calls Eurostat to further expand on these.

Following this, we support the call on Eurostat to expand the indicators on universal health coverage, using those that depict the various components of universal health coverage, including out-of-pocket expenditure on health care, health care coverage, indicators geared to measuring access to quality chronic condition care and management, specific information on groups that are vulnerable to discrimination in healthcare and health inequalities. Furthermore, we believe that patient-centred indicators on access should be included, taking into account EPF’s recommendations for indicators on access in addition to the self-reported unmet need for medical examination and care indicator.

How do we ensure tracking progress?

When proposing a mechanism to set goals for progress in reducing unmet need, the opinion recognises the differing starting points of Member States. The opinion notes that the selection of the precise targets is a political rather than technical process. There is no suggestion for comparison of milestones or timelines however. If each Member State is to set its own targets and pace, how and when can we track progress?

These opinions are giving a great insight on how we can improve healthcare systems, and we are also wondering how the European Commission and the Council will follow up on the recommendations.

From our side, we will keep working on Access to Healthcare in 2018 and beyond, implementing the Roadmap to Achieving Universal Health Coverage for All by 2030.

Contact person:

Katie Gallagher, EPF Policy Adviser.