The European Health Forum Gastein EHFG in the Austrian Alps is each fall the most important exchange for EU health policy makers. At this year’s event, the “empowered patient” was a key topic in many presentations, along with the expectation that she and he will help to balance national health budgets and improve overall health. More than a buzz word – and a cure for an ailing health system?
EHFG president Helmut Brand tried to ignite a somehow draggy press conference in which speakers observed the lack of European visions and national enthusiasm. “If I ask my students about visas they automatically think about credit cards”, the professor for public health at Maastricht University stated. A Europe without borders “is a big success story”, Brand beamed, however the implementation is a rather technical matter and thus for many not overly arousing.
A more critical view was offered by George Papandreou, former Greek Prime Minister, who held the EHFG 2014 key note opening speech. He supposedly rather skillfully manoevered his country through crisis and earned the reputation of “one of the top global thinkers for making the best of Greece’s worst year in 2010”.
In reference to this, he noted many deficits of the European Union in terms of “democracy, transparency and participation” and demanded unconventional approaches – “let’s think out of the box”, a fashionable expression for setting out to new horizons.
EU Inequality: One third of Greeks without health insurance!
Which ones Papandreou left open and his underlying message that “only healthy people provide for a healthy economy” may sound to some of his fellow countrymen a bit cynical. One third of the Greece population is still without work and after one year of unemployment one loses insurance coverage. If a Greek becomes sick and is lucky he is admitted to one of the “solidarity hospitals”, otherwise he will not find treatment.
While many participants refrained from becoming too specific in formulating recipes how to cure European Health, a new element introduced to this forum became more explicit: life twitter and life cartooning. Especially the latter conveyed messages which depicted major health issues on the continent. It is, in many ways, overloaded with bureaucracy, too expensive while slow in adapting to new technology like e-health, above all inequal.
Poor people and less affluent nations don’t receive the full benefits. These funny, humourous and ironic drawings were an essential contribution to the conference and opened a new channel of communication and reflection.
Health Citizenship: Will patients become co-producers of health?
The lunch workshop “patient empowerment”, organized by the European Patients’ Forum EPF in cooperation with Sanofi, the world’s fifth largest pharmaceutical company shed more light on how to get people more involved in their own health. While attendees munched tapas, the chairlady Tamsin Rose and the panelists tried very convincingly to explain the empowerment strategy and make it lively.
Ilona Kickbush, Global Health Programme Director in Switzerland introduced a new term to the debate which later at the closing panel was reverberated by EPF director Nicola Bedlington: Health Citizenship.
Outgoing Health Commissioner Borg: We are not united in health, but seperated
Ms. Kickbush was assisted, among others, by two representatives of patient groups. Stanimir Hasardzhiev of Bulgaria apparently knew by his own experience what patients go thorough in his impoverished country and he fiercely pleaded for equal treatment in the EU. The situation of this EU member is much worse than in Greece. He called for “adequate, available, accessible, affordable medical care”.
Ian Banks, a British medical doctor, also went through the misery of bad health. He suffered from blindness and deafness before he was cured. As the president of the European Men’s Health Forum he is concerned about the deteriorated health of men in general throughout the continent with the need for more prevention. Even in well-to-do nations men seem to care much less about their health and regular checkups than women.
Other panelists supported these views and quoted the outgoing health commissioner Tonio Borg with “we are not united in health, but separated”, pointing at discrimination and violation of human rights. Therefore many Gasteiners were curious to hear the commissioner-designate Vytenis Andruikaitis, a Lithuanian medical doctor and former health minister of his country.
Sara Riggare: When a real patient takes the floor
Building trust and unity by emphasizing “promotion, protection, prevention” is in his view the service which needs to be delivered to Europe’s citizens, in the atmosphere of “cooperation and acting together”, as Andruikaitis stressed, with the goal to make health the stepping stone for a new European unity. Some life tweets displayed on public screens offered support, but did not underestimate the efforts in the concert of 28 member states with highly diverse economies, cultures and histories.
Politics, also and especially in health related matters, is the art to forge compromises. Therefore, beyond the miracle of a united and borderless Europe, the steps towards more equity and equal treatment will be slow and to some extent even boring, as rightfully pointed out at the initial press round. Would it help to involve more grassroots patients’ groups? Or to borrow an expression of Peter O’Donnell, associate editor of the European Voice, would this make “the piano swim”?
At first sight, Sara Riggare did not really fit into an illustrious round of professors talking about public health leadership. She is a PhD candidate at Sweden’s Karolinska Institute with the title “Chief Patient Officer”. She was speaking and moving about cautiously, not to say abruptly, and soon she revealed why. At the age of 13 during a joyous fete around midsummer, her legs all of a sudden did not obey any more the commands of her nerves. Parkinson. She showed pictures, very touching, before and after the outbreak.
Assisted by her family, the girl took it as an early challenge to confront herself with the uncertainties of life. Sara fought back, engaged herself in patient groups and helped to found so called “Quantified Self Meetup Groups”. There are 176 groups with 35,714 members in 120 cities and 37 countries by now. They have developed new techniques to self-monitor themselves and their medication, generating a lot of unity and exchange of information as much as lowering costs.
Missing link in EU health: Will Commissioner-Designate Andruikaitis discover it?
Is this the missing link in EU health policy, not only to talk about the empowered patient, but a more pro-active involvement of grassroots groups? Could this make the difference, which Pandandreou and Borg were so concerned about? Dr. Andruikaitis has the political power now to prescribe treatment and, if necessary, perform surgery.
See also Satu Lipponen’s contribution “10 things you should know about EU health politics” -> https://www.eusja.org/10-things-you-know-about-eu-health-politics/ and “No silver bullet against Ebola” -> https://www.eusja.org/no-silver-bullet-vs-ebolaeurope-safetrade-not-aid/