The context - access to healthcare as a priority
Access and affordability of healthcare is a priority for the European Union. The European Pillar of Social Rights proclaimed that “everybody shall have timely access to quality, affordable, preventive, and curative healthcare”. The Pillar and the European Pillar of Social Rights Action Plan adopted in 2021 have reinforced the broad consensus at the EU and national level to work towards closing gaps in accessibility and affordability of healthcare. In that regard, the Commission is committed to explore new tools to measure access to healthcare.
The project - monitoring the performance of public health
The objective of the INEQHEALTH project is to support DG SANTE’s work in monitoring, in a very comprehensive way, the performance of healthcare systems in EU Member States. Specifically, the project aims at analysing healthcare systems’ redistributive impact, financing schemes, affordability and accessibility, and financial sustainability in the medium- and long-run.
First, the project investigates the redistributive impact of government spending in healthcare. Public healthcare services are normally funded by public resources and made available to those who need it; i.e., their cost at the time of consumption is usually subsidised by the government. The benefits obtained from accessing and using these kind of public services are usually referred to as Social Transfers in-Kind (STiKs), in the sense that beneficiaries do not receive an amount of cash but goods (such as medicines) and/or services (such as medical treatments). Although STiKs represent 30% of social benefits in the EU, their impact on poverty or inequality is currently not measured at the EU level, unlike the impact of social transfers in cash. The project fills this gap by looking at the impact of health STiKs on a range of different inequality and poverty measures.
The second aim of the project is to analyse affordability and access to healthcare, which is one of the targets of the UN Sustainable Development Goals, and part of the European Pillar of Social Rights. Furthermore, different action plans at the EU level evidence the commitment to achieve full accessibility to healthcare. Data on unmet medical and dental needs and on healthcare catastrophic out-of-pocket spending allows for an exhaustive analysis. In addition, heterogeneity analyses for different vulnerable groups are performed.
Third, another dimension of the INEQHEALTH project is the distributional impact of healthcare systems’ financing schemes. On the one hand, the impact of reforms affecting the financing of public health systems is analysed using the tax-benefit microsimulation model EUROMOD. This model allows, for example, to look at the budgetary and distributional impact of reforms on taxation and/or social security contributions. On the other hand, the work explores stylized scenarios concerning possible changes in funding sources (e.g. switching from social security contributions to universal taxation), and how these affect inequality and poverty.
Lastly, the project looks at the generational fairness and long-term sustainability of health care systems. Public healthcare systems entail a redistribution from the young generations to the old, since young individuals are largely paying for older individual’s healthcare. Moreover, older individuals use, on average, more health services and products. This leg of the project analyses the sustainability of healthcare financing schemes given ongoing demographic trends. Additionally, the redistributive impact of health STiKs adopting a lifetime approach is investigated.
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