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Dr Klaus Theo Schroeder

by Lloyd Davis

whcc europe 2008 121Dr Schroeder is the German Secretary of State for Health.

I’m blogging this live from the translation feed so I apologise for some of the disjointed sentences.

From our point of view Health is a value in itself - the WHCC discussing the various challenges.

In the EU of 27 states, we are all facing exactly the same challenges - smaller, aging populations. On the one had this is a challenge, but at the same time we are also developing new techniques and technologies.

We want to look particularly for the opportunities. We have €240bn of which €115bn is statutory insurance. health is also the largest sector in the economy employing 11% of the workforce. Against this background we have to consider money spent as an investment. So we have to answer the question - how can we use limited funds the best. I’d like to outline our reforms from a German perspective. You may know that we have two different financing systems - roughly 70m people are insured by statutory insurance paying a percentage of your wage, a solidarity system. The smaller part pay for private insurance. We have developed a strategy of improving efficiency and quality in providing health services to such a large population.

We are making gradual introduction of competition into this sytem. The system of statutory insurance has been simplified from complexities that had grown up historically based on profession or work group. We have the principle that if you want to join a particular provider, you have the right to do so, so we have a method for balancing out risks between different social groups. We have also introduced competition in provision. At the macro level we have the regulations from Parliament, a legal framework - medical services are rendered based on what is medically necessary. It just says who does what, not how it is done. Then at the middle level there is a joint committee between insurance, doctors, dentists and hospitals. This is helping to make healthcare more patient-focused. At the micro level, we want more competition to be introduced but also more integration and co-operation. There are three parameters to facilitate this - adequate remuneration systems, the changing role of patients - increases in choice and willingness to exercise this choice and thirdly the collation of patient data in the electronic health record and the central IT infrastructure to support it (which must also be compatible with other european systems).

I’d like to finish on prevention. We offer relatively good healthcare provision, but our preventive efforts are not yet as efficient as we’d like. The aging population must be kept healthy as long as possible to minimise any burden. So we need to do more in this direction to enable people to take on their part, playing an active role for longer.

Q: Do you think there’s an appetite for compatibility?
A: What I meant was that in telematics we need to make them compatible because there’s a great readiness and interest in travel. It is clear that we have a responsibility for funding our own systems, but commonality offers great benefits - the size of the european market is an incentive for the pharma market to develop better treatments.

Q: We are all waiting for the services directive to be published by the EC - what does the german government plan to do?
A: we think we are justified in saying that we have been active in bringing forward this directive. We have not spoken to the new commissioner yet, but we are ready to do so. It seems that it will be difficult to get it into the parliamentary timetable. We see the necessity to have a framework across member states and we will support the new commissioner as much as possible.

Q: Which other countries do you look to for examples of healthcare reform?
A: Health systems are difficult to compare, but there are elements that we have in common. In the Netherlands there have been reforms to