Towards cost-effective health care - Should more be done to promote health and prevent disease?

6 May 2013

Investing in health promotion and disease prevention would keep people healthy and active for longer, reducing healthcare expenditure in the long term, heard participants in this Policy Dialogue.

Michael Hübel, Head of Unit ‘EU Health Programme and chronic diseases’ at the Directorate-General for Health and Consumers, European Commission, said the problem is that European healthcare systems are still essentially being operated as if their sole purpose were to treat infectious disease.

Hübel warned that today we’re seeing epidemics of chronic disease across the world. But he argued that many of these diseases are preventable because they’re linked to diet, amount of exercise and tobacco consumption, among other health determinants and social factors.

He cited unhealthy diet, physical inactivity, and tobacco and alcohol use among the biggest risk factors in Europe, and warned that the differing social and economic situations of EU citizens are producing health inequalities.

Moreover, he listed creating smoke-free environments, warning about the dangers of tobacco use, banning tobacco and alcohol advertising, raising taxes on tobacco and alcohol, reducing the salt content of food, replacing trans-fats in food with polyunsaturated fat, and promoting public awareness about diet and physical activity among cost-effective ways to promote healthy lifestyles.

In an effort to promote cost-effective health care, the European Commission is evaluating healthcare systems in order to make country-specific recommendations, said Christoph Schwierz, Policy Analyst ‘Sustainability of Public Finances’ at the Directorate-General for Economic and Financial Affairs, European Commission.

The 2012 Fiscal Sustainability Report revealed that 22 member states face major challenges to the sustainability of public finances of a medium to long-term nature, so the Commission will have to promote the kind of change and structural reform that will address these financing problems, Schwierz said.

Healthcare systems in Europe are slowly becoming more integrated but in some countries they remain extremely fragmented, said Pascal Garel, Chief Executive of the European Hospital and Healthcare Federation (HOPE).

Garel said that due to a lack of primary care, there is still too much inappropriate hospitalisation in Europe. Doctors of public health are seen as lower-ranking, and doctors are neither sufficiently trained nor spend enough time on health promotion or disease prevention, he added.

Improving health requires a multi-disciplinary and cross-policy response encompassing nutrition, education, physical activity, health care, employment, urban planning and social networks, said Caroline Costongs, Deputy Director of EuroHealthNet.

She warned that road traffic costs the EU €25 billion through air pollution and €153 billion through injuries every year. Physical inactivity costs up to €300 per EU citizen per year, while cardiovascular disease and cancer cost the EU €169 billion and €124 billion respectively, she said.

Meanwhile, health inequalities account for 20% of healthcare costs in the EU, she said.

Costongs argued that public health policies concerning health promotion and disease prevention can be part of the solution. Adopting more cost-effective approaches to preventing disease and achieving health outcomes can reduce healthcare costs, while at the same time benefitting wider society by contributing to a healthier and more productive workforce and reducing demand for welfare.