Trends in EU Health Care Systems

For decades, the nations of the European Union wrote the book on universal health coverage. Recent economic developments, however, have created problems ranging from widening inequities of care to growing numbers of uninsured - a progression expertly described by Win de Gooijer in Trends in EU Health Care Systems.

De Gooijer’s dual background as an economist and the CEO of Dutch health care corporations, together with his broad international experience, give him a unique understanding of his subject. He traces world economic currents that have affected quality of and access to health care throughout the EU - trends that took years to develop, but are coming to rapid fruition. Comparative illustrations from Europe and the US show national interests at odds with global ones, as governments transfer social responsibilities to market-driven agencies. Included in his discussion:

- Expansion versus reform: a forty-year analysis of Europe’s health care systems

- Why governments cannot completely control the always-evolving dynamics of health care

- Ethical and medical issues arising from the continent’s changing politics

- Predictions on future directions in EU health care—how much change is possible, how much is necessary.

Some may find De Gooijer’s ideas startling, and the book is bound to be the subject of controversy. But it is critical reading for health care managers and policymakers, politicians and insurers, advanced students of public health - in short, anyone looking to Europe for the next phase of this far-reaching evolution.

"This book is a very important contribution to the debate about the future direction of health policy in Europe. It captures the economic and social trends that underpin health systems with a keen and objective eye and poses some very challenging questions about the future. It will not be a comfortable read for politicians but it is a book that must be read." Brian Edwards, President of the European Hospital and Health Care Federation (HOPE).

"The concept of subsidiarity is prohibitive to a sound discussion of health care systems on a European level. Economic principles dominate the debate and their consequences for health care are hardly understood. The author bridges the gap between economic and health care developments and wrote a book that is essential reading for policy makers and health care managers who really care." Rob Koning, Past President of the European Health Management Association (EHMA).

"The future development of European health policy should not be an exclusively political affair. Hospital managers should also be actively involved, particularly as regards the design and organization of present and future European hospitals. For this purpose, this book is a useful and well-founded manual. It not only clarifies the dangers, but also points to the challenges and possible alternative policy options. Therefore, this book should be in the boardroom of each and every European hospital." Willy Heuschen, Secretary-General of the European Association of Hospital Managers (EAHM).

"Win de Gooijer brings immense clarity to a complex issue.  In this book, he draws major and new conclusions, and raises many challenging questions.  We hope this book will draw the attention it deserves." Gérard Vincent, President International Hospital Federation.

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"This 12-chapter volume discusses the history, development, and future directions of the EU health care systems. The author describes how health care, economics, and politics are intertwined in society. The influence of 2 extremes, private initiative and commanding government, is reviewed. Movements of societies between these extremes and their consequences are described. The foundation of the EU health care systems, namely solidarity in access to health care, is now at risk because of movement to an exclusive free market model. Ideas about building a strong economy within the EU while taking care of the needy, including solidarity in health care, are discussed.

This important, timely, and well-referenced text clearly points out the consequences of free market economics vs. economics overseen by commanding governments and their effects on health care systems."

Dietlind L. Wahner-Roedler, MD, Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN

• Amsterdam, The Netherlands

  Win Gooijer

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