September 29, 2009
The latest results of the Euro Health Consumer Index (www.healthpowerhouse.com) further confirm the superiority of Bismarckian social philosophy over the Beveridge approach, at least as far as the patient is concerned. Bismarck countries, characterised by compulsory third party insurance systems, feature as the most consumer friendly health systems from the perspective of the patient and the Netherlands topped the rankings this year by an almost unprecedented margin. As a citizen of the home of Beveridge, your correspondent has long been an admirer of the approach taken by the Netherlands where government have stepped away from trying to run the healthcare system in favour of creating a pleural market of payors and providers which well informed consumers can navigate with relative ease due to the high levels of transparency. By contrast the paternalistic approach of Beveridge sees governments taking almost complete control of the system and, despite efforts to introduce competitive dynamics in the margins, the overwhelming responsibility for management remains with bureaucrats at the centre.
In my early years in the healthcare business Mrs Thatcher would proudly proclaim the success of UK healthcare because, as a percentage of gross domestic product, healthcare spend was lower in the UK than anywhere in the developed world. This was achieved at the expense of both service and, more importantly, outcomes. The Netherlands, by contrast, has a system which generates high performance in both service and outcomes which, in theory, should translate into patient and voter satisfaction. I wonder if the politics of health are so straightforward. Good healthcare systems are to the credit of the political leaders or are they, as the Health Consumer Powerhouse suggests, the result of deeply seated attitudes which change little from generation to generation?
These and other matters of interest to the industry and policy makers will feature in the Medtech Forum next week in Brussels (http://www.medtechforum.eu). Johan Hjertqvist, Founder and President of Health Consumer Powerhouse, will chair a Policy Debate on “access to high-quality care”. If you are not coming, you may be missing out.
John WilkinsonAuthor : MedTech Europe