Transcript The Future of health care in Europe University College London 16 May 2011 Michael Hübel European Commission DG Health and Consumers.

The Future of health care in Europe
University College London 16 May 2011
Michael Hübel
European Commission
DG Health and Consumers
Challenges
Economic situation
:
growing health gaps
Ageing
Population
Citizens’ expectations
Pandemic and
Bioterrorism Threats
Globalisation
Internationalisation of health
care delivery
Lifestyle Related
Diseases
New Technology
and Innovation
Migration
Health and social policy…
“Die Medizin ist eine
soziale
Wissenschaft, und
die Politik ist
nichts weiter als
Medizin im
Großen.“
Rudolf Virchow
(1848)
…and other policies
Defense 17th cent. on
Consumer protection
(Professional regulation )
19th cent.
Social Protection 20th cent.
Economic – 21st Cent
Health care sector
Labour force
participation
T. Hobbes “The social contract” 1652
This role of the health care sector could become
more important as life expectancy increases
France
Germany
UK
2000
102
99
100
2005
104
101
102
USA
101
103
Oldest age at which at least 50 percent of a
birth cohort projected to be still alive
Source: Vaupel J et al – see also Christensen K, Doblhammer G, Rau R, Vaupel JW. Lancet. 2009 Oct
3;374(9696):1196-208.
Currently healthy life years are not increasing in line
with life expectancy
EU Healthy life years at birth, males - Eurostat
55-64
45-54
35-44
25-34
15-24
longstanding illness is a major issue for
the working age population
men
women
men
women
men
women
men
women
men
women
0%
10%
20%
30%
40%
Health problem
50%
60%
70%
80%
90%
100%
No health problem
Prevalence of longstanding illness or disability EU
2008
Source EU SILC 2008
health problems are associated with early
retirement and inactivity
Employed
Unemployed
Retirement or
early retirement
Other inactive
0%
10%
20%
30%
40%
50%
Health problem
Source EU SILC 2008
60%
70%
80%
90%
100%
No health problem
Prevalence of longstanding illness EU
2008
Main causes of illness and disability
Non chronic diseases
20.61%
Other chronic diseases
3.94%
CVD
22.52%
Diabetes mellitus
1.99%
Digestive diseases
3.94%
Muscoloskeletal diseases
4.03%
Respiratory diseases
4.12%
Sense organ diseases
6.23%
Neuropsychiatric
conditions
20.27%
Cancer
12.36%
* Disease burden in the WHO-EURO Region, Projections for 2015. DALYs: Standard DALYs (3% discounting, age weights) - Baseline
scenario. Source: WHO http://www.who.int/healthinfo/global_burden_disease/projections/en/index.html
Much is preventable…
20
18
16
14
12
10
8
6
4
2
% of deaths caused by key risk factors
Source: Global health risks: mortality and disease attributable to selected health risks. WHO 2009, table 1 – high income countries
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EU role? - General Principles for
EU action on health
EU Treaty
public health (168)
other policies in health– eg internal
market, health and safety at work
EU Health Strategy 2008-2013
Common values in health systems
EU Treaty – Article 168
A high level of human health protection shall be
ensured in all policies
Union action shall
complement national policies
be directed towards improving public health
respect responsibilities of MS for the definition of their
health policy and for the organisation and delivery of
health services
Encourage complementarily of health services in
cross-border areas
Commission to promote MS cooperation, guidelines,
indicators, exchanging best practice
EU Health Strategy – Shared
values
Universality, access to good quality
care, equity, solidarity
Health is the greatest wealth
Health in all policies
Global health
Together for Health: A strategic Approach for the EU 2008-2013 COM (2007)630
Council Conclusions - 2006
Common Values in Health Systems
Universality - no-one is barred access to
health care;
Solidarity – finance and management of
health services ensures accessibility to
all
Equity - equal access according to need,
regardless of ethnicity, gender, age,
social status or ability to pay
EPSCO Council 2 June 2006
Health in all policies approach
Health largely
determined by
factors outside of
health care
services
Need for action by
a range of sectors
across society
EU Action on health care
Free movement:
travel and work
within EU
Professional
qualifications
Pharmaceuticals,
medical devices
Health and safety at
work – working time
Cross border health
care
Patient Safety
Determinants approach
Social and economic situation
Unhealthy
diet
CVD
Cancer
Type 2
diabetes
Physical
inactivity
Tobacco
use
COPD
Mental
health
Figure: Causal factorsquality
of major non-communicable disease
Environmental
Alcohol
Musculoskeletal
disorders
Oral
health
EU Action on Health
Determinants
Tobacco
Nutrition and physical
activity
Alcohol and drugs
Mental health
Environment and
health
Social determinants
and health
inequalities
EU Disease Prevention
Cancer
Mental disorders,
Alzheimers
Cardiovascular
disease
Rare diseases
…
Health threats
Communicable
disease control
Pandemic
influenza
Deliberate release
Health in the future: Europe
2020
A smart, sustainable and inclusive economy
75% of the 20-64 year-olds to be employed
at least 20 million fewer people in or at risk of poverty and social
exclusion
3% of the EU's GDP (public and private combined) to be invested in
R&D/innovation
greenhouse gas emissions 20% lower than 1990
20% of energy from renewables
20% increase in energy efficiency
Reducing school drop-out rates below 10%
at least 40% of 30-34–year-olds completing third level education
7 Flagship initiatives
Innovation Union - (including healthy and active
ageing)
European platform against poverty and social exclusion
(including health inequalities, and mental health)
Youth on the move
Resource-efficient Europe
An industrial policy for the globalisation era
An agenda for new skills and jobs
Digital Agenda for Europe
Health in Europe 2020: Innovation
platform for healthy and active ageing
increase healthy
life years by 2
years by 2020
Innovation in
health technology
and health
systems
Health in Europe 2020: European platform
against poverty and social exclusion
“poor people
should not have to
suffer poor health”
John Dalli – Commissioner
for Health and Consumer
Policy
Challenges to health care sector
Health promotion and prevention
Strengthen cooperation with other
sectors – social care, employment,
education
Fair cost containment.
Preventable chronic diseases
Risk factors
Drugs
Cancer screening
CVD
…
Tertiary
Prevention:
Patients
Alcohol
Diseases
Genetic
predisposition
Secondary Prevention:
Risk groups
Nutrition
Primary
Prevention:
Population
No diseases
A reflection process on chronic
diseases
Promotion/prevention/
treatment
Citizen/patient/professional
Individual/societal
Research/Innovation
EU/national/local
Public policy/stakeholders
UN Summit September 2011
Final reflections
Breaking down barriers
a need for integration –
society/sectors
New alliances
Empowerment – inequalities
EU role: support the process
Thank you!