Zoltán Massay-Kosubek

“Never deprive someone of hope; it might be all they have.” ~ Jackson Brown Jr.

Following a summary on relations between Healthcare costs and budget cuts published on EurActiv in march 2012, I try to further develop this idea which might be an always green subject of budget discussions, especially under the seemingly never-ending financial and economic crisis. The preparation of the 2013-2020 EU budget period is ahead of us, and it is of utmost importance to consider at least twice we spend our money for. Here we go.

European tradition of Healthcare Systems

As a starting idea, the European healthcare systems are widely known as flagships and success stories for the rest of the world to achieve the ambitious global goal of universal health coverage backed by WHO.

Neither is the analysis of the U.S. health care system is subject of this entry nor am I an expert of this field, but to better understand my starting point, it is worth to have a small general comparison between the amount and the effectiveness of the U.S. and European spending. Without quoting precise numbers I simply refer to the general opinion which agrees upon that the huge amount spent for the U.S. healthcare system is not in line with its effectiveness – without achieving the general [compulsory] health coverage. In light of the U.S. model we may appreciate the accomplishments of the European model.

Obvious links between the health conditions and the successful crisis management

It is useless to lay great stress on the negative impacts of the financial crisis on the health conditions of the population. If people have no jobs they can spend even less for preserving their physical condition (since healthy diet ex. is often considered as some kind of luxus), not to mention the serious mental diseases such as depression which may occur in these situations. All those physical and mental illnesses affect negatively the other family members, and the downward spiral goes on. Thus, all these tendencies will badly damage Europe’s capacity to fight effectively the crisis.


The most commonly mentioned factor of the successful crisis management is nowadays economic growth. It might be true. But no economic growth is imaginable without a healthy population. Only healthy workers can boost economy and a stable healthcare system is as much important for the society as infrastructure for investments. Therefore, in my opinion, providing Europe with a viable healthcare system is a condition sine qua non for economic growth.

Why health budget cuts do affect badly the society?

Others believe in the positive results of budget cuts and low state dept deficit and they consider the use of these methods as a painful but necessary way forward in order to overcome the crisis an attain economic growth. Consequently, this approximation can badly affect the overall, and more precisely, the healthcare budget spending.

Now, I will tell you, why are we going with this approach to the wrong direction.

I am not in the position to decide whether budget discipline (usually defended by the political right side) or spending more (as often quoted by the political left side) can better stimulate the economic growth. I am not an economist but a health-specialist lawyer.

Hence, my believe is that if the health care systems in Europe lack the fundamental and necessary investments – let’s be clear: the sufficient budget spending – there will be neither economic growth nor successful crisis management with an unhealthy population. The public health disasters will have double negative affects on the budget: the missing workforce will need from the economy (and from the taxpayers’ money) on the one hand, and the hospital and pharmaceutical spending of the ill population will digest another large part of the health founds, on the other. And I did not pointed out the additional, huge costs of communicable diseases which may arise in every Winter period in the future.

Some experts say that the outbreak of next deadly epidemic following the H1N1 pandemic in 2009 through viral mutation is only a question of time.

Where can our public money be spent the most effectively?

Maybe, some attend a direct, clear answer after this presentation but I will disappoint those wishes: I don’t know. It is a purely politic decision and the responsibility is up to the decision makers. And I am aware of the European reality that this future decision will be influenced and shaped by several clashes of the different European decision makers (Member States, European Parliament, Commission). But these questions (and the numbers of each budget entries) are still open.


An important additional aspect to this political decision might be the appropriate consideration of the real added value of healthcare spending for the society. Although it will not have direct economic benefits, more workplaces or economic investments, their positive and indispensable indirect effects can be hardly overestimated.

I remain at your disposal.

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Related earlier updates:

The Choice is Yours: either You Drink or… Re-think the EU’s Alcohol Strategy

(Cover photo “Doctor, Doctor!” The greek language has two different words for doctor. The english language only has one…
© Duncan Hull)

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