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Health spending fell across the European Union in 2010, as cash-strapped governments curbed outlays to help cut budgetary deficits, according to Health at a Glance: Europe 2012, a new joint report by the OECD and the European Commission.
This drop in spending per person and as a percentage of GDP reverses increases seen in the years before the economic crisis, when health spending per person grew two or three times faster than incomes in many countries. From an annual average growth rate of 4.6% between 2000 and 2009, health spending per capita fell to -0.6% in 2010. This is the first time health spending has fallen in Europe since 1975.
In Ireland, health spending fell 7.9% in 2010, compared with an average annual growth rate of 6.5% between 2000 and 2009. In Estonia, health expenditure per person dropped by 7.3% in 2010, following growth of over 7% per year from 2000 to 2009, with reductions in both public and private spending. In Greece, estimates suggest that health spending per person fell 6.7% in 2010, reversing annual growth of 5.7% between 2000 and 2009.
The report cautions that the reduction or slowdown in spending in nearly all EU countries may have a long-term impact on health care outcomes.
Spending on disease prevention accounts for only 3% of total health spending
Governments, under pressure to protect funding for acute care, are cutting other expenditures such as public health and prevention programmes. In 2010, on average across EU countries, only 3% of health budgets was allocated to prevention and public health programmes in areas such as immunisation, smoking, alcohol drinking, nutrition and physical activity. The report notes that spending on prevention now can be much more cost-effective than treating diseases in the future.
More than half of adults in the European Union are now overweight, and 17% are obese. Obesity rates have doubled since 1990 in many European countries, and now range from 8% in Romania and Switzerland to over 25% in Hungary and the United Kingdom. Obesity and smoking are the major risk factors for heart disease and stroke which accounted for over one-third (36%) of all deaths across EU countries in 2010.
Finland, France and Hungary have recently introduced taxes on unhealthy food and drink as part of their efforts to counter obesity. These "fat taxes" are designed to change eating habits, while at the same time generating public revenues that may be used to support other public health and prevention programmes.
The OECD and European Commission's Health at a Glance: Europe 2012 presents key indicators of health status, determinants of health, health care resources and activities, quality of care, health expenditure and financing in 35 European countries, including the 27 EU member states, 5 candidate countries and 3 EFTA countries.
Other findings from the report include:
Health spending as a share of GDP was highest in the Netherlands (12%) in 2010, followed by France and Germany (11.6%). The share of GDP allocated to health was 9.0% on average across EU countries, down from 9.2% in 2009.
Doctors: Despite concerns of shortages, the number of doctors per capita has increased in almost all EU member states over the past decade from an average 2.9 per 1 000 population in 2000 to 3.4 in 2010. Growth was particularly rapid in Greece and the United Kingdom.
Generalist/Specialist balance: There are now many more specialists than GPs in nearly all countries due to lack of interest in traditional "family medicine" practice and a growing remuneration gap. The slow growth or reduction in generalists raises concerns about access to primary care for certain population groups.
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