France is the 2006 winner of the Euro Health Consumer Index; Ireland and Lithuania provide the worst health care in Europe

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France is the 2006 winner of the Euro Health Consumer Index; Ireland and Lithuania provide the worst health care in Europe
By Finfacts Team
Jun 26, 2006, 20:35

The Euro Health Consumer Index 2006 identifies the most consumer-friendly health care system in the European union, as rated by 27 Index indicators. The 2006 Index includes all the 25 EU public healthcare systems plus Switzerland for reference.

France emerges as the 2006 winner of the Euro Health Consumer Index, "with a technically efficient and generously providing healthcare system". France scores 576 out of 750 maximum points. 2005 years winner, the Netherlands, now takes the silver position, followed by Germany. Estonia and Slovakia gets the highest ranking in the category "value for money".

In five categories, covering 28 performance indicators, Ireland scores 359 points out of a potential 750.

The survey points out that Irish waiting times are long, medical outcomes are bleak, that there is a high level of infant deaths, and a high number MRSA infections in Irish hospitals.

Ireland also fares badly in terms of patients' rights. The survey also pointed out that Ireland lacks a Patients' Ombudsman, the right to a second opinion, or an all-day telephone or web-based healthcare information service.

Taking a strong consumer view, the 2006 Euro Health Consumer Index seeks to add to already existing evaluations by institutions like WHO and OECD. Introducing a different perspective, its Index ranks how user-friendly the national healthcare turns out around the Union.

Analysing the position of the consumer as shown by the 2006 Index, Euro Health finds for example that:

- Only four EU countries out of 25 offer some kind of provider catalogue (just one with a quality ranking).

- Three out of four national systems cannot treat your cancer within three weeks.

- In only one out of three you have direct access to a medical specialist.

- The same goes for the right to a second opinion.

- Every second country blocks the patient´s access to her own medical record.

- Two out of three governments delays the introduction of new pharmaceuticals into the reimbursement system.

To see the full results: EHCI 2006 grid
To read the report: EHCI 2006 Report

Results in the BFB (Bang for Buck) Score sheet

The outcome of the BFB exercise is shown in the table below. Even with the square root exercise described in a previous section of the report, the effect is definitely to dramatically elevate all the less affluent nations in the scoring sheet.

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Content summary

France emerges as the 2006 winner of the Euro Health Consumer Index (EHCI), with a technically efficient and generously providing healthcare system. France scores 576 out of 750 maximum points. It is sometimes argued that “the French healthcare system has severe budget deficit problems”. The author would like to note that budget deficits in public sector areas, which are not financed for performance and work in a situation of competition, are more or less arbitrary! As long as “France, S.A.” is reasonably solvent, black or red figures in its healthcare system are not very significant.

The scoring has intentionally been done in such a way that the likelihood that two states should end up sharing a position in the ranking is almost zero. It must therefore be noted that France, the Netherlands, Sweden, Switzerland, Germany and Luxembourg are really very difficult to separate, and that very subtle changes in single scores modify the internal order of these six top countries.

One interesting thing about the top six states is that they achieve their top positions in very different ways. Sweden reaches 4th place almost entirely because of a solid victory in the Outcomes quality discipline, and with very poor performance on Accessibility.

(Radically improving Medical Outcomes is a much more laborious and much longer process than reducing waiting times.) This means that if healthcare officials and politicians took to looking across borders, and “steal” good things from their EU neighbours, there is a good chance for a nation to come much closer to the theoretical top score of 750.

In southern Europe, Spain and Italy provide excellent healthcare services. Real excellence in southern European healthcare seems to be a bit too much dependent on the consumers’ ability to afford private healthcare as a supplement to public healthcare for these countries to reach top scores.

A mixed performance is shown by the UK, which wins out on healthcare information.

The overall U.K. score is dragged down by waiting lists and uneven quality performance.

The CEE member states are doing surprisingly well, considering their much smaller healthcare spend in Purchasing Power adjusted dollars per capita. However, readjusting from planned to consumer-driven economies does take time. Slovenia and Estonia, being the smallest ships to turn around, seem to lead this subgroup, and are clear winners in the academic exercise in our value-for-money adjusted Index – the “Bang-for-the-Buck” score.

Think-tank Health Consumer Powerhouse is the leading European provider of consumer information on health care. The Powerhouse is dedicating ideas and resources to the development of consumer empowerment action. It analyses health care and compare the outcomes, designing consumer information tools like health care system and Illnesses indexes, consumer press and education. It is registered Swedish entity working from Stockholm and Brussels and soon also in Canada.