Even before the COVID-19 epidemic exploded on the world, including in Europe, the EU healthcare systems were already facing several challenges such as an ageing population and chronic diseases, antimicrobial resistance, vaccination prejudice, together with the persistent digital divide. Chronic diseases have revealed to be the leading cause of mortality and morbidity in Europe and research suggests that complex conditions such as diabetes and depression will become an even heavier burden in the future.
Universal access to health services is threatened both by financial and non-financial barriers and it is clear that all this has contributed to increasing the demand and availability of treatment and personalised lifelong care. This will create an even heavier stress on health systems that the current structure will no longer be able to sustain in the long term.
Today, the COVID-19 pandemic is placing health systems across Europe under enormous strain since the unprecedented surge in demand for intensive care has rapidly brought health systems to a breaking point, with health workers being stretched thin and medical resources becoming scarce. However, not all European countries are impacted to the same extent, thus revealing the different levels and capacity in being able to cope with this external shock.
While the first and foremost priority is to deal with the immediate effects of the pandemic, the EU must learn from this crisis and reflect on how its Member States, and the EU itself, can become more resilient. We should not forget that the resilience of a healthcare system is not only related to the capacity to activate extraordinary and extra measures but also to its pre-existent level of overall sustainability (equity, access, efficacy and efficiency). For a long time, in order to build more sustainable healthcare systems, the scientific community, patients and institutions all around Europe have been calling for a paradigm shift. The latter involves integrating patient care across the continuum of life, bridging the gap between acute, treatment-driven demand and normal, healthy living.
Therefore, investments must be made in health promotion and prevention and, at the same time, in actions aimed at promoting equity that can significantly contribute to better health (i.e. poverty reduction, social inclusion and security). Health outcomes and health inequalities are indeed mainly affected by the social, economic and environmental determinants of health, such as the conditions in which we are born, grow, live, work and age. This is the reason why policies adopted in all sectors can have a profound effect on population health and health equity. The State of Health in the EU’s 2019 Companion Report recalls that after the financial crisis, the Commission drew up, through the European Pillar of Social Rights, a set of principles to support EU citizen rights and safeguard social standards in a fast-changing world. One of these principles declares that everyone has the right to timely access to good quality, affordable, preventive and curative health care, accessibility being a vital and multi-dimensional aspect of health system performance.
Despite a limited room for manoeuvre, the past European Commission mandate made some significant steps forward in terms of health policy. However, more efforts are needed since Europe must tackle unprecedented challenges affecting people’s health. Indeed, although healthcare services fall under the responsibility of national authorities, their capacity to address their public’s needs can be impacted by EU policies, or by the absence of them.