The Inefficiency and Inequalities of THe Health Care Systems of Western Europe [antikvár]

The objective of this paper is to argue that substantial inequalities exist in health and in health care in Western Europe and that the impact of the State in the last 30 years in mitigating these inequalities has been limited. Most health care systems in Western Europe purport to strive after greater equality but in fact do not perform in ways consistent with these objectives. Evidence to support these arguments will be drawn from the countries of the European Community and, in particular, from the British health care system.The paper is divided into three sections. The first brief section is concerned with the distinction between health care and health status and this is emphasised by the enunciation of three maxims for health care researchers. The second section is concerned with inequalities for health care (inputs) and health status (outcomes). The final section examines the future of health and health care policy in Western Europe and presents an analysis of some general problems which are likely to beset all health care systems, and some specific policies which may increase equality, if societies wish to achieve such an objective (which is doubtful).1. Health Care and HealthOne of the most popular errors amongst health service researchers, commentators, and citizens is to assume that an increase in the provision of health care leads to an improvement in the health of the individual or the nation. It is important to distinguish between:i)health care inputs (e.g. hospital beds, health care expenditure, doctors, nurses etc.)ii)health care services: a measure of throughput (e.g. number of cases, patient days).iii)health status outcomes: a measure of the output of health care services.It is foolish to believe that increases in health care inputs and throughputs lead to increases in health status outcomes, i.e. increased inputs do not always and everywhere lead to increased outputs. For increased inputs to increase the outputs of the health care syjstem, the effects of such inputs on the health status of individuals should be positive and beneficial. The fact of the matter is that most health care has not been evaluated in a scientific145