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Published in: Israel Journal of Health Policy Research 1/2019

Open Access 01-12-2019 | Integrative article

Structural effects of the information revolution on tax-funded European health systems and some potential policy responses

Author: Richard B. Saltman

Published in: Israel Journal of Health Policy Research | Issue 1/2019

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Abstract

The ongoing information revolution has re-configured the policymaking arena for tax-funded health systems in Europe. A combination of constrained public revenues with rapid technological and clinical change has created a particularly demanding set of operational challenges. Tax-funded health systems face three ongoing struggles: 1) finding badly needed new public revenues despite inadequate GDP growth 2) channeling additional funds into new high-quality provider capacity 3) re-configuring the stasis-tied organizational structure and operations of existing public providers. This commentary reviews key elements of this new information-revolution-driven context, followed by a consideration of seven specific policy challenges that it creates and/or worsens for tax-funded European systems going forward.
Literature
1.
go back to reference Engels F. The making of the English working class. Leipzig; 1845. Engels F. The making of the English working class. Leipzig; 1845.
2.
go back to reference Marx K, Engels F. The German ideology. Moscow: Marx-Engels Institute; 1932. Marx K, Engels F. The German ideology. Moscow: Marx-Engels Institute; 1932.
3.
go back to reference Josephson M. The robber barons: the great American capitalists. New York: Harcourt Brace and Company; 1934. Josephson M. The robber barons: the great American capitalists. New York: Harcourt Brace and Company; 1934.
4.
go back to reference Fiorina M. Unstable majorities: polarization, Party sorting and political stalemate. Palo Alto: Hoover Press; 2017. Fiorina M. Unstable majorities: polarization, Party sorting and political stalemate. Palo Alto: Hoover Press; 2017.
5.
go back to reference Saltman R, Figueras J, editors. European health care reform: analysis of current strategies. Copenhagen: WHO Regional Office for Europe; 1997. Saltman R, Figueras J, editors. European health care reform: analysis of current strategies. Copenhagen: WHO Regional Office for Europe; 1997.
6.
go back to reference Kovner A, Neuhauser D, editors. Health services management: readings and commentary. Ann Arbor: Health Administration Press, Second Edition; 1983. Kovner A, Neuhauser D, editors. Health services management: readings and commentary. Ann Arbor: Health Administration Press, Second Edition; 1983.
8.
go back to reference Kingdon J. Agendas, alternatives, and public policies. 2nd ed. New York: Harper Collins College Publishers; 1995. Kingdon J. Agendas, alternatives, and public policies. 2nd ed. New York: Harper Collins College Publishers; 1995.
10.
go back to reference Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E. Netherlands: health system review. Health Syst Transit. 2016;18(2):1–240 Epub 2016/07/29. PubMed PMID: 27467715.PubMed Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E. Netherlands: health system review. Health Syst Transit. 2016;18(2):1–240 Epub 2016/07/29. PubMed PMID: 27467715.PubMed
11.
go back to reference Busse R, Blumel M. Germany: health system review. Health Syst Transit. 2014;16(2):1–296 xxi. Epub 2014/08/15. PubMed PMID: 25115137.PubMed Busse R, Blumel M. Germany: health system review. Health Syst Transit. 2014;16(2):1–296 xxi. Epub 2014/08/15. PubMed PMID: 25115137.PubMed
12.
go back to reference Saltman R, Busse R, Figueras J, editors. Social health Insurance Systems in Western Europe. London: Open University Press/McGraw-Hill Education; 2004. Saltman R, Busse R, Figueras J, editors. Social health Insurance Systems in Western Europe. London: Open University Press/McGraw-Hill Education; 2004.
15.
go back to reference Pollock AM, Shaoul J, Vickers N. Private finance and “value for money” in NHS hospitals: a policy in search of a rationale? BMJ. 2002;324(7347):1205–9 Epub 2002/05/23. PubMed PMID: 12016191; PubMed Central PMCID: PMCPMC1123165.PubMedPubMedCentralCrossRef Pollock AM, Shaoul J, Vickers N. Private finance and “value for money” in NHS hospitals: a policy in search of a rationale? BMJ. 2002;324(7347):1205–9 Epub 2002/05/23. PubMed PMID: 12016191; PubMed Central PMCID: PMCPMC1123165.PubMedPubMedCentralCrossRef
17.
go back to reference Yates J. Why are we waiting? An analysis of hospital waiting lists. Oxford: Oxford University Press; 1987. Yates J. Why are we waiting? An analysis of hospital waiting lists. Oxford: Oxford University Press; 1987.
20.
go back to reference OECD. Health at a glance. Paris: OECD; 2012. OECD. Health at a glance. Paris: OECD; 2012.
22.
23.
go back to reference Ringard A, Sagan A, Saunes I, Lindahl A. Norway: health system review, health systems in transition. European Observatory on Health Systems and Policies: Brussels; 2013. Ringard A, Sagan A, Saunes I, Lindahl A. Norway: health system review, health systems in transition. European Observatory on Health Systems and Policies: Brussels; 2013.
24.
25.
go back to reference Oljaz M, Nielsen A, Rudkjobing A, Birk H, Krasnik A, Hernandez-Quevedo C. Denmark: health system review. Health systems in transition. European Observatory on Health Systems and System Policies: Brussels; 2012. Oljaz M, Nielsen A, Rudkjobing A, Birk H, Krasnik A, Hernandez-Quevedo C. Denmark: health system review. Health systems in transition. European Observatory on Health Systems and System Policies: Brussels; 2012.
27.
go back to reference SOU. Effectiv Vard. Stockholm: Statens Offentliga Utredningar; 2016. p. 2. SOU. Effectiv Vard. Stockholm: Statens Offentliga Utredningar; 2016. p. 2.
28.
go back to reference SOU. Gor Det Enklare! Stockholm: Statens Offentliga Utredningar; 2012. p. 33. SOU. Gor Det Enklare! Stockholm: Statens Offentliga Utredningar; 2012. p. 33.
33.
34.
go back to reference El Erian M. World economy set to take turn towards genuine growth: Financial Times; 2018. El Erian M. World economy set to take turn towards genuine growth: Financial Times; 2018.
35.
go back to reference Giles C. Weak productivity growth hampers global recovery: Financial Times; 2017. Giles C. Weak productivity growth hampers global recovery: Financial Times; 2017.
36.
go back to reference Gov.UK. Spring Statement 2018: Philip Hammond’s speech. 2018. Gov.UK. Spring Statement 2018: Philip Hammond’s speech. 2018.
37.
go back to reference Milne R. Market crash concerns hang over Norway’s $1 trillion oil fund: Financial Times; 2018. Milne R. Market crash concerns hang over Norway’s $1 trillion oil fund: Financial Times; 2018.
38.
go back to reference Jones C. Eurozone slowdown stokes concern over resilience of post-crisis recovery: Financial Times; 2018. Jones C. Eurozone slowdown stokes concern over resilience of post-crisis recovery: Financial Times; 2018.
39.
go back to reference Jones C, Pooley C. Slower German growth raises concerns for Eurozone outlook: Financial Times; 2018. Jones C, Pooley C. Slower German growth raises concerns for Eurozone outlook: Financial Times; 2018.
40.
go back to reference Hannon P. Eurozone commercial activity slowed again in May. Wall Street J. 2018. Hannon P. Eurozone commercial activity slowed again in May. Wall Street J. 2018.
41.
go back to reference McKee M, Karanikolos M, Belcher P, Stuckler D. Austerity: a failed experiment on the people of Europe. Clin Med (Lond). 2012;12(4):346–50 Epub 2012/08/31. PubMed PMID: 22930881.CrossRef McKee M, Karanikolos M, Belcher P, Stuckler D. Austerity: a failed experiment on the people of Europe. Clin Med (Lond). 2012;12(4):346–50 Epub 2012/08/31. PubMed PMID: 22930881.CrossRef
42.
go back to reference Mladovsky P, Srivastava D, Cylus D, Karanikolos M, Evetovits E, Thomson S, et al. Health policy responses to the financial crisis in Europe. Policy summary 5. Brussels: European Observatory on Health Systems and Policies; 2012. Mladovsky P, Srivastava D, Cylus D, Karanikolos M, Evetovits E, Thomson S, et al. Health policy responses to the financial crisis in Europe. Policy summary 5. Brussels: European Observatory on Health Systems and Policies; 2012.
43.
44.
45.
go back to reference Ward A. NHS to stop funding 16 cancer treatments: Financial Times; 2015. Ward A. NHS to stop funding 16 cancer treatments: Financial Times; 2015.
46.
go back to reference Cole A, O'Neill P, Sampson C, Lorgelly P. Barriers to uptake of minimal access surgery in the UK. London: Office of Health Economics; 2018. Cole A, O'Neill P, Sampson C, Lorgelly P. Barriers to uptake of minimal access surgery in the UK. London: Office of Health Economics; 2018.
47.
go back to reference Smyth C. Hospitals still dangerously full as doctors warn they are exhausted: The Times; 2018. Smyth C. Hospitals still dangerously full as doctors warn they are exhausted: The Times; 2018.
48.
go back to reference Campbell D. NHS patients waiting for hospital care top 4m for first time in a decade: Guardian; 2017. Campbell D. NHS patients waiting for hospital care top 4m for first time in a decade: Guardian; 2017.
49.
go back to reference Morris J. The growing problem of treatment waiting times. Quality Watch. London: Nuffield Trust; 2018. Morris J. The growing problem of treatment waiting times. Quality Watch. London: Nuffield Trust; 2018.
51.
go back to reference Chanturidze T. Personal communication; 2017. Chanturidze T. Personal communication; 2017.
52.
54.
go back to reference Committee on the Future of Healthcare. Slaintecare Report. Dublin: House of the Oireachtas; 2017. Committee on the Future of Healthcare. Slaintecare Report. Dublin: House of the Oireachtas; 2017.
55.
go back to reference Kangas O, Kalliomaa-Puha L. Finland: The government’s social and healthcare reform is facing problems. European Social Policy Network Flash Report 2018/2. Brussels: European Social Observatory; 2018. Kangas O, Kalliomaa-Puha L. Finland: The government’s social and healthcare reform is facing problems. European Social Policy Network Flash Report 2018/2. Brussels: European Social Observatory; 2018.
56.
go back to reference Steinglass M. King’s speech to parliament heralds end of Dutch welfare state: Financial Times; 2013. Steinglass M. King’s speech to parliament heralds end of Dutch welfare state: Financial Times; 2013.
58.
go back to reference Gainsbury S. The bottom line: Understanding the NHS deficit and why it won’t go away: Nuffield Trust; 2017. Gainsbury S. The bottom line: Understanding the NHS deficit and why it won’t go away: Nuffield Trust; 2017.
59.
go back to reference King’s Fund. A New Settlement for Health and Social Care. London; 2014. King’s Fund. A New Settlement for Health and Social Care. London; 2014.
60.
go back to reference Sylvester R. How to give the NHS extra billions it needs: The Times of London; 2018. Sylvester R. How to give the NHS extra billions it needs: The Times of London; 2018.
61.
go back to reference Coates S. Tax rise needed to plug 95 billion pound black hole in NHS: The Times; 2018. Coates S. Tax rise needed to plug 95 billion pound black hole in NHS: The Times; 2018.
62.
go back to reference Gainsbury S. NHS funding boost: the need to manage expectations: Nuffield Trust; 2018. Gainsbury S. NHS funding boost: the need to manage expectations: Nuffield Trust; 2018.
63.
go back to reference Thomson A. The social care crisis is about more than money: The Times of London; 2018. Thomson A. The social care crisis is about more than money: The Times of London; 2018.
65.
go back to reference Fishing for funds. The Economist; 2018. p. 50–1. Fishing for funds. The Economist; 2018. p. 50–1.
68.
go back to reference Coulter A. Engaging patients in healthcare. Basingstoke: Open University Press; 2011. Coulter A. Engaging patients in healthcare. Basingstoke: Open University Press; 2011.
69.
go back to reference Saltman R, Allin S, Mossialos E, Wismar M, Kutzin J. Assessing health reform trends. In: McKee M, Figueras J, editors. Health systems: health, wealth, society and well-being. Maidenhead: Open University Press/McGraw-Hill Education; 2011. Saltman R, Allin S, Mossialos E, Wismar M, Kutzin J. Assessing health reform trends. In: McKee M, Figueras J, editors. Health systems: health, wealth, society and well-being. Maidenhead: Open University Press/McGraw-Hill Education; 2011.
74.
go back to reference Richmond C. NHS waiting list have been a boon for private medicine in the UK. CMAJ. 1996;154(3):378–81 Epub 1996/02/01. PubMed PMID: 8564909; PubMed Central PMCID: PMCPMC1487523.PubMedPubMedCentral Richmond C. NHS waiting list have been a boon for private medicine in the UK. CMAJ. 1996;154(3):378–81 Epub 1996/02/01. PubMed PMID: 8564909; PubMed Central PMCID: PMCPMC1487523.PubMedPubMedCentral
75.
76.
77.
go back to reference Eurofound. Care homes for older Europeans: Public, for-profit and non-profit providers. Luxembourg: Publications Office of the European Union; 2017. Eurofound. Care homes for older Europeans: Public, for-profit and non-profit providers. Luxembourg: Publications Office of the European Union; 2017.
78.
go back to reference Kettl D. Shared power. Washington: Brookings Institution; 1993. Kettl D. Shared power. Washington: Brookings Institution; 1993.
79.
go back to reference Hood C, Margetts H. The tools of government in the digital age. London: Palgrave MacMillan; 2007.CrossRef Hood C, Margetts H. The tools of government in the digital age. London: Palgrave MacMillan; 2007.CrossRef
80.
go back to reference Saks M, Chamberlain J, Dent M, editors. Professional health regulation in the public interest: international perspectives. Bristol: Policy Press; 2018. Saks M, Chamberlain J, Dent M, editors. Professional health regulation in the public interest: international perspectives. Bristol: Policy Press; 2018.
81.
go back to reference Hagen T, Saltman R, Vrangbaek K. New strategies for elderly Care in Denmark and Norway. Eur Secur. 2015;21(2):23–6. Hagen T, Saltman R, Vrangbaek K. New strategies for elderly Care in Denmark and Norway. Eur Secur. 2015;21(2):23–6.
86.
go back to reference Pickard J, Tetlow G. Private companies make 831 million pounds profits from NHS contracts: Financial Times; 2017. Pickard J, Tetlow G. Private companies make 831 million pounds profits from NHS contracts: Financial Times; 2017.
87.
go back to reference Editorial. Carillion’s failure does not vindicate Corbyn: Financial Times; 2018. Editorial. Carillion’s failure does not vindicate Corbyn: Financial Times; 2018.
88.
go back to reference Swedish Social Democratic Party. Our common approach to gain in welfare. 2014. Swedish Social Democratic Party. Our common approach to gain in welfare. 2014.
89.
go back to reference Milne R. Swedish angst grows over tensions in public-private model: Financial Times; 2016. Milne R. Swedish angst grows over tensions in public-private model: Financial Times; 2016.
90.
go back to reference Pressman J, Wildavsky A. Implementation. Berkeley: University of California Press; 1973. Pressman J, Wildavsky A. Implementation. Berkeley: University of California Press; 1973.
91.
go back to reference Castle-Clarke S, Edwards N, Buckingham H. Falling short: why the NHS is still struggling to make the most of new innovations. London: Nuffield Trust; 2017. Castle-Clarke S, Edwards N, Buckingham H. Falling short: why the NHS is still struggling to make the most of new innovations. London: Nuffield Trust; 2017.
94.
go back to reference WHO Global Strategy on People-Centered and Integrated health Services. Service Delivery and Safety Series. Interim Report. Geneva: WHO; 2015. WHO Global Strategy on People-Centered and Integrated health Services. Service Delivery and Safety Series. Interim Report. Geneva: WHO; 2015.
95.
go back to reference McKeown T. The modern rise of population. London: Edward Arnold; 1976. McKeown T. The modern rise of population. London: Edward Arnold; 1976.
97.
98.
go back to reference Donnelly L. NHS provokes fury with indefinite surgery ban for smokers and obese: Telegraph; 2017. Donnelly L. NHS provokes fury with indefinite surgery ban for smokers and obese: Telegraph; 2017.
99.
go back to reference Knapton S. Why British Summer Time has an unexpected impact on the NHS: Telegraph; 2018. Knapton S. Why British Summer Time has an unexpected impact on the NHS: Telegraph; 2018.
101.
go back to reference Terlep S, Mathews A, Cimilluca D. CVS to Buy Aetna for $69 Billion, Combining Major Health-Care Players: Wall Street Journal; 2017. Terlep S, Mathews A, Cimilluca D. CVS to Buy Aetna for $69 Billion, Combining Major Health-Care Players: Wall Street Journal; 2017.
Metadata
Title
Structural effects of the information revolution on tax-funded European health systems and some potential policy responses
Author
Richard B. Saltman
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Israel Journal of Health Policy Research / Issue 1/2019
Electronic ISSN: 2045-4015
DOI
https://doi.org/10.1186/s13584-018-0284-2

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