Overview

The key messages of this policy brief published by the European Observatory on Health Systems and Policies are as follows:

To transform health systems, countries will need to spend more public funds on health, and also use those funds more efficiently and effectively.

• Governments often have major concerns about the persistent growth of public spending on health and about the long-term sustainability of health financing. Health policy-makers are finding it increasingly challenging to make the case for adequate health budgets as price growth, demographic shifts and other factors put significant upwards pressure on health spending.
  

• Health systems and services need to transform to meet their objectives and to become resilient to future challenges.
  

• Transformation requires a mix of more efficient (better) and increased (more) public spending on health.

• Health systems can spend their resources better by optimizing resource allocation and by focusing on priorities which provide value for money. Some good investments to consider include:

  • primary health care and prevention which reduces the need for more expensive and intensive treatments;
  • steps to strengthen and sustain the health care workforce to ensure there are enough staff in the appropriate care areas to deliver high quality, accessible services;
  • digital innovations which, if carefully selected and integrated, can enhance efficiency, access and quality of care;
  • improved access to mental health care to address population and societal needs;
  • ongoing evaluation of pharmaceutical pricing and reimbursement models to make sure that prices paid reflect good value; and
  • coverage policies that provide better financial protection and access to needed services.
• Resources can be spent better in all countries, but additional public expenditure on health is also required now and over time. Institutional rigidities and political economy factors mean efficiency gains and reallocation of funding from one priority area to another are not always possible. Even when they are, they are unlikely to be enough on their own to deliver on strategic goals such as high-quality, affordable and accessible care.
  

• Public sector budgeting has a strong political dimension and health policy-makers need the evidence, skills and willingness to negotiate effectively for resources.

• There is no one-fits-all solution to negotiating for additional resources for health, but a strategic approach based on evidence-informed narratives and effective fiscal governance arrangements can help.

The other Tallinn policy briefs: