Health Consumer Powerhouse

New EU country recommendations: The European Commission wants better value-for-money healthcare

Blogginlägg   •   Jun 02, 2013 11:43 CEST

The other day the European Commission presented its review of the member states and recommendations for action to meet requirements from the stability pact and additional EU goals. For a number of members, the EC points to the need for better and more sustainable policy for health, healthcare and elderly care. In Brussels, there is a growing concern about the financial sustainability of EU welfare systems.

From the Health Consumer Powerhouse point of view it is of special interest to notice that the EC now directly addresses lack of productivity and efficiency in the systems for healthcare and long term care, affecting value-for-money delivery – an aspect of the Euro Health Consumer Index measurement.

The Netherlands

“Implementation of the plans to reform long-term care would help curb the fast-rising costs of ageing and would thus support the sustainability of public finances. In this regard, the quality and accessibility of long-term care has to be maintained at an adequate level,” says Brussels.

The EC does not address what HCP has described as NL healthcare having too large a proportion of in-patient care, adding to the explanation of high Dutch healthcare costs. However, this very criticism is directed by the EC to Czech healthcare, as stated by Brussels:

The Czech Republic

“The expected increase in health and long-term care spending also provides a substantial contribution to the cost of ageing and the large sustainability gap. Reforms aimed at improving the efficiency of the health system via cost containment and more market-oriented solutions have been implemented in recent years in the Czech Republic. However, problems still exist.

Compared to other Member States, the Czech healthcare system tends to be excessively centered on hospital care, which gives rise to inefficiencies. There is scope to improve the provision of care in the most clinically appropriate and cost-effective way, for example by moving to day surgery and reducing inappropriate lengths of stay in acute care hospitals.”


“In long-term care, improved cost-efficiency of public spending and cost-saving measures of health prevention and rehabilitation, and for the creation of better conditions for independent living should be explored in the light of the relatively high cost of institutional care in Belgium.Continue to improve the cost-efficiency of public spending on long term institutional care”, advises the EC.

Assessing Austrian performance, Brussels takes a similar position as for Belgium:


“Medium and long-term pension and health care expenditure projections pose a risk to

sustainability of public finances. Long-term care expenditure projections also point

at a sustainability risk, although to a lesser extent…However, an accelerated harmonisation of retirement ages of men and women as well as a link of the statutory retirement age is still missing. The issue of the fiscal sustainability of the health care and long-term care system has to be addressed, also in view of the increasing need and demand for long-term care provision. The recent policy measures taken in the health sectors are likely to go in the right direction, although careful assessment of their effectiveness has to be carried out in the coming years. There is scope to enhance prevention, rehabilitation and independent living to contain future costs of long-term care. “

It is evident that Brussels is becoming increasingly worried about the impact on health and healthcare from the growing numbers of older Europeans and how to ensure long term care solutions meeting the increasing demand. This goes also for Finland, where Brussels also would like to see a more robust administrative design of public healthcare, with larger healthcare regions:


“The productivity growth in public services has not matched the productivity growth in

the wider economy whilst the burden linked to an ageing population is increasing.

Whereas the principles for reforming municipalities have been established, mergers

will remain voluntary although financial incentives from central government will be

available. It is expected that the on-going reform of social and health services will not

lead to any significant reduction in the current number of health-care districts.”


For France, which has been rewarded with a long list of necessary reforms in many areas to fulfill promises already made by Paris, the EC in just a few words asks for better value for healthcare money: “Increase the cost-effectiveness of healthcare expenditure, including pharmaceutical spending.”

Read all recommendations at:

Johan Hjertqvist