By JAVIER ESPINOZA
Traditional sources of funding health care in Europe have been branded obsolete and unaffordable. The need for innovation has never been stronger and while some countries, such as the Netherlands and Switzerland, are embracing change, others are resisting any significant overhaul. Indeed, the notion of free, state-backed health care is ingrained in the psyche of most Europeans.
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Reformers want to reduce the state's role in health-care delivery and introduce a competitive element. Those against change are adamant that a health-care system without state involvement is health care without a heart. Good for the rich, calamitous for the poor. It is an issue heavily clouded by emotion. But many feel that without innovation, crumbling state-backed systems will collapse as they struggle to cope with aging populations, soaring overheads and, more recently, mounting budget deficits.
The statistics paint a bleak picture. According to the Organization for Economic Cooperation and Development, the European Union will see an increase in health expenditure of 350% by 2050, whereas at the same time the economy is only set to expand by 180%.
Some work has already been done to estimate the real impact on future expenditures. Friedrich Breyer, a professor of economics at the University of Konstanz in Germany, calculates that in Germany alone between 2020 and 2030 there will be a huge spike in the number of elderly people alongside an enormous drop in young and working-age people. "This will mean a dramatic increase in individuals' payroll tax contribution rates to health care to 20.7% in 2030 and over 23% in 2040," he says. This compares to just 11.4% in 1980.
Protesters in London campaign against job cuts and increasing private-sector involvement in the National Health Service.
So which countries offer the closest to a sustainable and effective health-care model and what can others, like the U.K., learn from them? Health-care specialists point to the Netherlands and Switzerland as models to follow in which funding comes from a mixed pool of sources and patients have more control over their health.
Unlike the U.K. health-care system, where the state manages and delivers the services, systems in the rest of Europe, particularly Switzerland, the Netherlands and to some extent Germany, rely more on a system of private insurance. Switzerland has been hailed as the least over-protective system. In that country health insurers are the ones who determine their fees and the services they provide—as long as they adhere to the basic services agreed in the country's Health Insurance Law.
Also unlike the U.K., patients incur fees to cover some ambulance and boarding costs. However, the Swiss authorities also provide subsidies for poorer patients. The system is broken down into the country's 26 cantons (or regions), which largely look after their own services, without relying on a centralized system. Individuals have the advantage of choosing which health service better fits their needs by opting for different competing insurers
