European health policy: must redefine its raison d'etre

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7047.1622 (Published 29 June 1996) Cite this as: BMJ 1996;312:1622
  1. Tessa Richards

    Market model has failed: more imaginative individual national policies are needed

    Market ideology, language, principles, and practices have been incorporated into the healthcare reforms in Europe over the past 10 to 15 years. The rationale has been to increase efficiency in largely government run health services and put a brake on escalating healthcare costs. The reforms have also promoted private sector funding and provisions of services and increased sharing of costs by patients. The resulting public-private mix has assumed different forms, but experts on healthcare policy throughout Europe agree that no one has got it right. Healthcare costs have continued to rise in 19 of the 20 countries of the OECD (Organisation for Economic Cooperation and Development), and gains in efficiency have been more than offset by rising inequity in the quality and distribution of care.

    In recognition of this, the World Health Organisation (WHO) has drawn up a charter—adopted last week by the member states of WHO's1 European region and reproduced on p 1663 of this week's BMJ. This underlines that the fundamental principle of healthcare reform should be to improve people's health, not contain costs. (Whether the British government supports this new move is unclear; its delegates were absent from the meeting that adopted the charter by consensus.)

    But if the market is not the solution to Europe's provision of health care, what is? This question was debated at a recent meeting of members of …

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