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Commonwealth Fund International Health News Brief: 2019, No. 5

International Health News Brief

Major Shake-Up of Private Health Insurance in Australia

0 min read

Country Correspondent: Sonĵ Hall

Despite billions of dollars in public subsidies each year, the share of Australians with private health insurance coverage continues to drop – from 80 percent in the early 1970s to approximately half that today. Premiums that often rise faster than inflation are partly responsible. But also to blame is consumer confusion over what’s in their coverage, which can leave many facing unexpectedly high out-of-pocket costs.

In an effort to stem the tide, the government has standardized insurance products into four categories and is now allowing discounts for younger people, which previously were not permitted under Australia’s “community rating” rules. Other changes include reduced wait times for mental health treatment, expanded women’s health services, coverage of travel and accommodation benefits for those in rural areas, and removal of coverage of most natural therapies.

International Health Policy Center Australia Newsletter Article Show Link Controlling Health Care Costs International

Quebec Commission Reports Increase in End-of-Life Care But Unequal Access

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Country Correspondent: Aisha Gomez and Roosa Tikkanen

Since passage of the 2015 End of Life Law, access to physician-assisted end-of-life care has dramatically increased across Quebec. By April 2019, more than 1,600 residents had received such assistance, and the number of people seeking assistance increased by 73 percent between 2016 and 2017 alone. In general, the law is viewed as socially acceptable, with cancer patients receiving most of the care (78 percent). Yet access to services remains unequal, with some arguing that individuals suffering from persistent pain but not facing foreseeable death should also qualify for assistance. A legal challenge seeks to clarify how institutions interpret the law.

International Health Policy Center Canada Newsletter Article Show Link Improving Health Care Quality International

New Taskforce Aims to Create National Framework for Telemedicine in Canada

0 min read

Country Correspondent: Aisha Gomez and Roosa Tikkanen

Although seven of 10 Canadians favor telemedicine, inconsistencies in regulations across provinces and territories are leaving some patients unable to access this “virtual care.” To reduce barriers, the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, and the College of Family Physicians of Canada launched a task force to review what regulatory changes are necessary to ensure equal access to telemedicine across the country. The task force will review existing bylaws, policies, and cost structures and explore alternatives for a national telemedicine framework, including licensing requirements, quality assurance, and best ways to capture health outcomes. The new body is set to deliver its recommendations by early 2020.

International Health Policy Center Canada Newsletter Article Show Link Improving Health Care Quality International

Burnout Prevalent Among French Physicians

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Country Correspondent: Angèle Malâtre-Lansac

Burnout is a major issue among physicians in general, and French physicians are no exception. A March 2019 review found an estimated 49 percent of doctors in France suffer from burnout, with 5 percent experiencing severe burnout. Junior residents, emergency physicians, and physicians with a high number of night shifts are at greatest risk. According to the study, burnout prevalence in medicine is two to three times higher than in other professions. The authors, citing previous research, say physician burnout may compromise patient care.

International Health Policy Center France Newsletter Article Show Link Controlling Health Care Costs International

Introduction of National Electronic Health Record in France a Success

0 min read

Country Correspondent: Angèle Malâtre-Lansac

Six months ago, a voluntary, shared electronic health record (dossier médical partagé, or DMP) was launched in France. In that time, more than 5 million adults have opted to open one. And starting in 2020, patients will be able to open their DMP directly online or with the help of a health care provider, whether a pharmacist, physician, or nurse. Although most providers in France were already using some form of electronic health record, a recent law mandated that the national health insurance program implement a fully interoperable electronic health record to help providers across different sectors of the health care system share information.

International Health Policy Center France Newsletter Article Show Link Improving Health Care Quality International

New German Law Seeks to Ensure More Timely Access to Care

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Country Correspondent: Michael Laxy

In Germany, people covered under the statutory health insurance system often face longer wait times for physician appointments compared to those with private insurance. A law passed in March aims to address the issue: it introduces incentives for physicians to allot more consultations hours to statutorily insured patients — 88 percent of the German population — while providing assistance to patients with finding available doctors and making timely appointments. An estimated EUR 600 million to 800 million (USD 663 million to 883 million) will be allocated annually for those additional services.

International Health Policy Center Germany Newsletter Article Show Link Improving Health Care Quality International

New Pay-for-Outcomes Pricing Models in Germany Focus on Immunotherapies

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Country Correspondent: Michael Laxy

New cell- or gene-based immunotherapies are often very expensive, despite the lack of rigorous, long-term clinical evidence of their effectiveness or safety. That’s why German payers are testing different reimbursement models that pay pharmaceutical manufacturers based on achieved health outcomes. One prominent example is the contract between a German insurance service provider and pharmaceutical giant Novartis for reimbursement of Kymriah, a cell-based leukemia therapy, under which the payer is refunded if a treated patient dies within a defined period. Another approach, followed by one of the largest statutory health insurance providers, advocates for a system of “dynamic price assessment” based on the most current postlicensing data.

International Health Policy Center Germany Newsletter Article Show Link Controlling Health Care Costs International

New Report on Health Care Affordability in Europe

0 min read

Country Correspondent: Roosa Tikkanen

A recent World Health Organization (WHO) Europe report examining financial hardship and unmet need for health services in 24 high- and middle-income European countries found that catastrophic health care spending is heavily concentrated among the poorest populations, with the majority of spending on outpatient drugs. Those countries with strong financial protections in place and low levels of unmet need were found to have the following features in common: universal coverage based on population entitlement; minimized out-of-pocket payments, particularly for poor people and regular users of health services; caps on out-of-pocket spending set at no more than 15 percent of total health spending; and adequate public health spending to ensure timely access to care.

International Health Policy Center Newsletter Article Show Link Improving Health Care Quality International

Survey: Europeans Hold Conflicting Views on Vaccination

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Country Correspondents: Roosa Tikkanen

A recent Eurobarometer survey requested by the European Commission has revealed contradictory beliefs about vaccines among residents of 16 European countries. While the vast majority of European Union citizens believe vaccination is effective at preventing infectious diseases, nearly half (48%) think vaccines can often produce severe side effects, and more than one-third (38%) think vaccines can cause the very diseases they are designed to protect against. The survey results will be used to inform targeted, coordinated action on vaccine-preventable diseases, including ways to prevent the spread of misinformation. The European Commission and the World Health Organization (WHO) will be hosting a Global Vaccination Summit in September in Brussels.

International Health Policy Center Newsletter Article Show Link Improving Health Care Quality International

WHO Reforms Focus on Primary Care, New Technologies, and Launch of ‘Learning Academy’

0 min read

Country Correspondent: Roosa Tikkanen

The World Health Organization (WHO) has announced its new priorities for the next five years, featuring a strong emphasis on primary care. The plans revolve around the “triple billion” target: one billion more people benefiting from universal health care coverage; one billion more being better protected from health emergencies; and one billion more enjoying better health and well-being. The agency also revealed it will create a new chief scientist role to focus on emerging technologies, as well as a chief of antimicrobial resistance. In addition, a new academy to be launched in Lyon, France, will aim to deliver multilingual learning, both online and in person, alongside a cutting-edge simulation center for health emergencies. The Massachusetts Institute of Technology will be among the international partners guiding the academy.

International Health Policy Center Newsletter Article Show Link Improving Health Care Quality International

In the Netherlands, Everyone Now Has Right to Nonurgent Care

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Country Correspondent: Margje Haverkamp

In March, Paul Blokhuis, the Netherlands health care secretary, expanded the rights of uninsured individuals by removing the prerequisite of “urgency” when it comes to providing care for the uninsured. Until now, health care providers were obligated to deliver only truly urgent medical care to such individuals. Commenting on the decision, Blokhuis said “a thriving country like the Netherlands cannot fail people in their weakest moments.” Residents of the Netherlands must purchase health insurance from a private insurer or pay a fine. Despite generous public subsidies for those who cannot afford premiums, more than 17,000 residents were uninsured in 2017.

International Health Policy Center Netherlands Newsletter Article Show Link Achieving Universal Coverage International

Dutch Citizens Promised Free Electronic Personal Health Records

0 min read

Country Correspondent: Margje Haverkamp

Starting in August, all Dutch citizens are promised access to a digital platform — a website or app — that contains all their personal health data. Patients are expected to gain easier access to their health system medical record as well as the ability to share their health data with other providers, such as hospitals and pharmacies. They also will be able to enter information like weight and blood pressure into their record. Companies creating the new digital platforms, which must be certified with a new label (MedMij), will receive EUR 7.5 (USD 8.28) for each person who uses his or her digital record at least once.

International Health Policy Center Netherlands Newsletter Article Show Link Improving Health Care Quality International

Survey: Most New Zealand Health Professionals Are Concerned About Unnecessary Medical Interventions

0 min read

Country Correspondent: Jennifer Moore

A survey of around 800 doctors and nurses conducted in late 2018 found that 68 percent consider the provision of unnecessary tests, procedures, or treatments to be a somewhat or very serious issue, up from 62 percent in 2016. An even larger share of health professionals, 84 percent, now actively discourage patients from seeking a particular procedure or test, or do not provide it at all, compared to 77 percent just two years before. The survey was conducted by the Choosing Wisely campaign, which is coordinated by the Council of Medical Colleges and supports the reduction of unnecessary tests, treatments, and procedures in health care.

International Health Policy Center New Zealand Newsletter Article Show Link Improving Health Care Quality International

Norway Announces New National Overdose Strategy

0 min read

Country Correspondent: Marianne Storm

Norway’s new strategy for addressing overdoses aims to reinforce existing efforts to prevent deaths. The strategy for 2019–2020, prepared by the Norwegian Directorate of Health, was developed in partnership with health service providers, patient organizations, regional centers for drug and alcohol use prevention, and the research community. The strategy includes levers to ensure better advice and guidance to patients regarding health and nutrition, a process for updating the knowledge base for implementation of targeted, evidence-based measures, and implementation of a standardized treatment package (patient pathway) for follow-up after nonlethal overdose to reduce local variation in response patterns. Availability of safe injection sites will also be expanded, as will access to substitution treatment and naloxone nasal spray.

International Health Policy Center Norway Newsletter Article Show Link Improving Health Care Quality International

Highly Specialized Care in Sweden May Soon Be Centralized

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Country Correspondent: Ulrika Winblad

Treatment for advanced stages of rare diseases in Sweden will be centralized at no more than five locations, the government has announced. The locations of the specialized care are to be decided in December 2019. A committee at the National Board of Health and Welfare (NBHW) has proposed starting with advanced surgery for endometriosis, treatment of gestational trophoblastic disease, and certain treatments within advanced fetal medicine. The pros and cons of the new approach, aimed at maximizing the volume of cases treated by specialist providers and improving quality of care, have been intensively debated during the past few years.

International Health Policy Center Sweden Newsletter Article Show Link Improving Health Care Quality International

Swiss Government Promotes Use of Electronic Vaccination Record

0 min read

Country Correspondent: Lars Hemkens

A project started by the Swiss government in 2011 to promote the newly developed electronic vaccination record has so far engaged 214,000 people, or 2.5 percent of the population, in using it. The vaccination record is a key element of the Swiss government’s Health 2020 strategy. Just like the conventional vaccination card, the electronic record provides users with an overview of previous vaccinations — but with a few clear advantages: the electronic system can provide reminders for recommended or missing vaccinations; it is centrally stored and therefore cannot be lost; and it allows people to access their information when traveling or during emergencies.

International Health Policy Center Switzerland Newsletter Article Show Link Improving Health Care Quality International

NHS Appoints England’s First Chief Midwife

0 min read

Country Correspondent: Adam Briggs

To help improve maternity care and promote safer births, the National Health Service (NHS) has appointed Jacqueline Dunkley-Bent as England’s first chief midwife. Dunkley-Bent, a visiting professor at Kings College London and London South Bank University, previously served as head of maternity, children, and young children for NHS England and has had a long career in the NHS as a midwife and nurse. As the most senior midwife in the country, she will lead the development of national maternity policy and assume responsibility for a range of initiatives, including implementing digital access to child medical records, providing greater access to physiotherapy for mothers after delivery, and improving breastfeeding rates.

International Health Policy Center Newsletter Article Show Link Improving Health Care Quality International

New Rules Set for Online Drug Purchases in U.K.

0 min read

Country Correspondent: Adam Briggs

The U.K.’s chief pharmacy regulator has set new rules to help protect people when buying medicines online. Following significant increases in the use of online pharmacies in recent years, the safeguards aim to both reduce the chance of people buying the wrong drugs and regulate access to addictive medicines. The new measures include: requiring additional identity checks for people buying medicine online; ensuring that prescription drugs can be purchased only after consultation with a health care professional; and requiring online pharmacies to check with a patient’s general practitioner before issuing medications that are potentially addictive or liable to abuse.

International Health Policy Center Newsletter Article

 

    Show Link Improving Health Care Quality International

    Editorial Team and Country Correspondents for 2019, No. 5

    0 min read

    Editorial Team

    Editor: Roosa Tikkanen

    Project manager: Aisha Gomez

    Country Correspondents

    Australia — Sonĵ Hall

    Canada — Aisha Gomez and Roosa Tikkanen

    International — Roosa Tikkanen

    France — Angèle Malâtre-Lansac

    Germany — Michael Laxy

    Netherlands — Marthe Haverkamp

    New Zealand — Jennifer Schulz Moore

    Norway — Marianne Storm

    Sweden - Ulrika Winblad

    Switzerland — Lars Hemkens

    United Kingdom — Adam Briggs

    Newsletter Article Show Link Improving Health Care Quality