Health policy responses to the financial crisis in Europe

Abstract

The global financial crisis that began in 2007 can be classified as a health \nsystem shock – that is, an unexpected occurrence originating outside the \nhealth system that has a large negative effect on the availability of health \nsystem resources or a large positive effect on the demand for health services. \nEconomic shocks present policy-makers with three main challenges: \n• Health systems require predictable sources of revenue with which to plan \ninvestment, determine budgets and purchase goods and services. Sudden \ninterruptions to public revenue streams can make it difficult to maintain \nnecessary levels of health care. \n• Cuts to public spending on health made in response to an economic \nshock typically come at a time when health systems may require more, \nnot fewer, resources – for example, to address the adverse health effects \nof unemployment. \n• Arbitrary cuts to essential services may further destabilize the health \nsystem if they erode financial protection, equitable access to care and the \nquality of care provided, increasing health and other costs in the longer \nterm. In addition to introducing new inefficiencies, cuts across the board \nare unlikely to address existing inefficiencies, potentially exacerbating the \nfiscal constraint. \nIn 2009, WHO’s Regional Committee for Europe adopted a resolution \n(EUR/RC59/R3) urging Member States to ensure that their health systems would \ncontinue to protect and promote universal access to effective health services \nduring a time of economic crisis. To date, there has been no systematic crosscountry \nanalysis of health policy responses to the financial crisis in Europe, \nalthough some overviews of health system responses to the crisis have been \npublished. This policy summary aims to address a gap in the literature by \npresenting a framework for analysing health policy responses to economic \nshocks; summarizing the results of a survey of health policy responses to the \nfinancial crisis in the European Region’s 53 Member States; and discussing \nthe potential effects of these responses on health system performance.

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