26 November 2010
Along with austerity measures to bring debt-laden countries into improved financial health will come some actions with an impact on healthcare and the health of people.
Some examples have a specific impact and might include increasing the patient co-payment, introducing new co-payments, or reducing public capital expenditure on healthcare infrastructure.
In other cases things are already happening: increasing premiums (Ireland), or increasing control of drug pricing (Spain).
Other actions will have a knock-on effect, such as increasing tuition fees which may impact student numbers and thus the supply of health professions (UK). Tighter access to debt will have some impact on new build in healthcare, as the ability of the state to finance new hospitals will be reduced along with willingness to fund the running costs (big hospitals cost hundreds of millions a year to run). Perhaps we may see some flight of research capacity as whole clinical research teams up-sticks and relocate to countries where investment in medical research is increasing (such as China and India).
And, as people find they are unable to afford to pay their health insurance, their costs are then picked up by the taxpayer. Countries with high rates of unemployment (many) will understand the carrying capacity needed to pay for the healthcare of the uninsured.
We know, broadly speaking, that people are happy with the quality of the healthcare that they receive. The real issue is always about gaining access to that care. To date, most EU countries appear able to manage this (despite these costs contributing to their debt burden).
But for countries facing austerity measures, under what circumstances might reduced access to care begin to manifest itself. The issue then will be increased burden of ill-health, with all its consequences.
Will we not have converted a debt crisis into a health crisis?EuroSante