EUROPEAN INSTITUTE OF MEDICINE E O M

European Academy of Sciences and Arts

Health is Wealth

Strategic Visions for European Healthcare at the Beginning of the 21st Century

Felix Unger

Health connex ’05

Vienna, September 30th, 2005

Baseline

EU 25 Member states with 460 million inhabitants

General: European Health Care Market25 % GNP, largest employer

Medicine: Cultural endeavour, how we deal with man

Costs: A function of aging population with increasing retirees, progress of medicine and economy

European Academy of Sciences and Arts

EUROPEAN INSTITUTE OF MEDICINE

E O M

Goal: - Health for all Europeans based to solidarity

- The decision to select a medical treatment

depends primarily on the benefit to the patient

and not on the cost

- Deliver optimal medicine based on the State

of the Arts

European Academy of Sciences and Arts

EUROPEAN INSTITUTE OF MEDICINE

E O M

- Consider mobility of the patient

- Clear Healthcare system in Europe

- based to solidarity and evidence

- reliable standards according the State of the Arts

- easy adjustable and applicable

European Academy of Sciences and Arts

EUROPEAN INSTITUTE OF MEDICINE

E O M

Report to the European Parliament „Health is Wealth“ (4.12.2003):

Patient–orientated and driven by medical professionals

Cluster III Medical Financing

Patient – Doctor – Nucleus

Cluster I Medical Arts Cluster II Medical Organization

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Patient – Doctor – Nucleus

Patient: - responsible for his own lifestyle and habits

- contributes by himself by prevention

- motivated to therapy

- increasingly mobile

- complies with medical recommendation

Doctor: - provides information

- informs and guides on therapeutic choices

- provides medical services

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Cluster I - Medical Arts:

Prediction – Prevention – Diagnosis – Therapy - Prognosis

Standards in all diagnostic / therapeutic procedures

Class I: efficient and evident

Class IIa: efficient, but empirical

Class IIb: less efficient and empirical

Class III: not efficient

Basis for: - understanding diseases and new cures by process orientated research

- quality control

- medical outcome studies

- control of the Health Care System

- basis for reimbursement (primary, secondary and tertiary costs)

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Cluster II - Medical Organization:

Homecare: - General Practitioner, clearing function for

hospitalization

- Specialists

Hospital: - to be sized to supply and demand by quality control

- Stimulation for Centers of Excellence

Long term care: - chronic ill, disabled, etc.

Full reimbursement according the classification I – III

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Cluster III - Medical Financing:

Dichotomy

Results in medicine Financing in medicine f (Demography and progress f (economy [taxes and income in the Medical Arts) of employees])

Systems in Europe

dual: - insurances mono: taxes - taxes - co-payment

Financing in medicine is a pure political decision

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Central Fund

Social Insurances Fund

Classification Total reimbursement of expenses

Medical Financing (National task)

Medical Arts (EU task) Medical Organization (EU task)

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Taxes

Patient - Doctor-Nucleus

Consequences of the concept “Health is Wealth”

1. Clear and simple reimbursement in Europe

2. Standards for health professionals

3. Establishing of regional centers of excellence and reference

4. Exchange of Health assessment - homogenous high level in Europe

5. Benefit to the patients

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M

Main conclusions

- Depoliticizing of medicine

- Professionalism of medical organization

Comment:

- Quadrature of the circle is easier

European Academy of Sciences and ArtsEUROPEAN INSTITUTE OF MEDICINE

E O M