OECD ministers fear that economic crisis may reduce investment in prevention of chronic disease

Health ministers and policy makers from 36 countries met in Paris last week to discuss ways to reduce spending on health care in the current economic climate without damaging the quality of care.

“The message is loud and clear that some objectives are so central and important that we cannot compromise,” said Anne-Grete Strøm-Erichsen, Norway’s health minister, at the close of the Organisation of Economic Co-operation and Development meeting on 7-8 October, which she chaired.

Amid huge financial pressure on OECD countries, whose health spending is on average 9% of gross domestic product (and more than 10% in seven countries), “access, quality, and prevention” are crucial in terms of dealing with future health challenges and ensuring better value for money, Ms Strøm-Erichsen said.

Countries around the world could make major savings simply by making their services more efficient, the OECD ministers agreed.

If all countries were to become as efficient as the best performers, people would live two extra years on average across OECD countries, for the same level of spending, the OECD has calculated. By contrast, a 10% increase in spending would achieve only a two month increase in life expectancy.

Also, care is currently coordinated so poorly in many countries that vast sums are wasted through duplication of effort. Clinical guidelines need to be improved to avoid unnecessary procedures and costly mistakes. And nearly half of healthcare errors, which occur in over 10% of hospital stays, could be prevented or avoided.

Pharmaceutical spending accounts for 17% of total health spending and 1.5% of GDP on average in OECD countries. Most countries have managed, since the global economic crisis hit, to reduce this spending by making better use of generic drugs and negotiating better pricing on new treatments.

Many countries are also attempting to cut administrative costs (which can account for as much as 10% of total healthcare budgets), and some have been forced to freeze or reduce wages.

“There are measures you can get away with for a while without damaging care,” said John Martin, the OECD’s director for employment, labour, and social affairs. “But the challenge is: how long you can do this for. How can you stop staff leaving, possibly moving to another country?”

But the greatest concern emerging from the Paris meeting was that financial pressure may lead to less investment in prevention of chronic disease, despite the fact that problems such as obesity are reaching “near epidemic” proportions and will incur huge health costs in the future if neglected.

In 1980 one person in 10 across the OECD was obese. Today, in half of the OECD countries every second person is obese or overweight.

“Urgent action is needed,” said the OECD’s secretary general, Angel Gurría, in a statement. “Parallels can be drawn with the economic crisis, which we continue to pay for dearly because of our collective failure to identify and deal with the causes. Obesity is a warning sign, and we cannot claim ignorance.”