EU analysis identifies risks and potential for improving health systems, including in Germany.

In one of his last official acts on 28 November last year, Health Commissioner Vytenis Andriukaitis published the Country Health Profiles of the EU Member States, Iceland and Norway. These provide an overview of the state of health systems in Europe. The reports continue the cycle ‘State of Health in the EU’, which started in 2016 in cooperation with the Organisation for Economic Cooperation and Development (OECD) and the Observatory on Health Systems and Policies. In addition to 30 country-specific profiles, an accompanying report highlights the main trends in Europe. 

The situation in Europe

On the downside, the report states that widespread vaccination hesitancy is a threat to public health across Europe, and that healthcare is still not fully accessible everywhere. Innovations to achieve a mix of skills among health workers - for example through task sharing and substitution of medical services - show great potential, particularly for pharmacists and nurses, and make systems more resilient. Promising examples of task shifting could be found across the EU, but unfortunately these are limited. The digital transformation holds great potential, especially for disease prevention, but could make losers of those who need it the most, namely older people or people with a low level of education and poorer health opportunities. Access to digital tools and applications is difficult for these people.

Germany often just average

It is often said that Germany has the best healthcare system in the world. However, in its ‘Country Health Profile 2019’, Germany does not always score well. The system is one of the most expensive and has the highest ratio of hospital beds, but often produces only average health outcomes. Life expectancy is below that of most Western European countries and the number of overweight adults is rising. The number of doctors and nurses is higher than in many other EU countries; however, there is currently a shortage of staff in rural and remote areas. Skill mix innovations, in which nursing staff are given more tasks, have not yet been implemented nationwide. Overall, there is a lack of regular, systematic and integrated performance evaluation of the various healthcare sectors in order to better understand processes and outcomes.

The good news

The analysis also shows that the German healthcare system offers almost universal health insurance coverage with a comprehensive range of benefits, and that access to healthcare is good. The number of people reporting an unmet medical need in Germany is almost zero percent, which is well below the EU average and is only surpassed by Malta, Spain and the Netherlands. This is mainly due to the fact that the costs of dental care, especially dental prostheses and orthodontics, are not fully covered and in some cases considerable co-payments have to be made.