How resilient is health financing policy in Europe to economic shocks? Evidence from the first year of the COVID-19 pandemic and the 2008 global financial crisis. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Thomson, Sarah; García-Ramírez, Jorge Alejandro; Akkazieva, Baktygul; Habicht, Triin; Cylus, Jonathan; Evetovits, Tamás
• Is Part Of: Health policy. Volume 126:Issue 1(2022)
• Page Start: 7
• Page End: 15
• Publication Date: 2022-01
• Subjects: COVID-19 -- Health financing -- Resilience -- Global financial crisis -- Austerity; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2021.11.002
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Health systems were weakened by policy responses to the 2008 crisis. Responses to COVID-19 reveal persistent weaknesses in health financing policy, particularly in countries with social health insurance schemes. To strengthen resilience, countries can reduce cyclicality in coverage and revenue-raising policy; increase public spending on health; and ensure that resources are used to meet equity and efficiency goals. Austerity is not an appropriate response to budgetary pressure because it undermines resilience. Abstract: The COVID-19 pandemic triggered an economic shock just ten years after the shock of the 2008 global financial crisis. Economic shocks are a challenge for health systems because they reduce government revenue at the same time as they increase the need for publicly financed health care. This article explores the resilience of health financing policy to economic shocks by reviewing policy responses to the financial crisis and COVID-19 in Europe. It finds that some health systems were weakened by responses to the 2008 crisis. Responses to the pandemic show evidence of lessons learnt from the earlier crisis but also reveal weaknesses in health financing policy that limit national preparedness to face economic shocks, particularly in countries with social health insurance schemes. These weaknesses highlight where permanent changes are needed to strengthen resilience in future: countries will have to find ways to reduce cyclicality in coverage policy and revenue-raising; increase the priority given to health in allocating public spending; and ensure that resources are used to meet equity and efficiency goals. Although many health systems are likely to face budgetary pressure in the years ahead, the experience of the 2008 crisis shows that austerity is not an option because it undermines resilience and progress towards universal health coverage.