News

The First Euro Consumer Diabetes Index will be launched September 30th
July 15, 2008

Empowerment of the diabetes patient is crucial. Diabetes is now becoming a pandemic all across Europe. The treatment of diabetes is complex, involving numerous lifestyle adaptations and requiring a great deal of teaching and support. Health Consumer Powerhouse is therefore currently working on the inaugural Euro Consumer Diabetes Index (Diabetes Index). The Project Manager for the Diabetes Index is Dr. Beatriz Cebolla. The Diabetes Index will be launched and published on September 30^th. 

The reference panel assisting in that work consists of:

Dr. Inge Duimel  ( Netherlands ),

Dr. Gabriel Gímenez Pérez ( Spain ),

Prof. Simon Pruna ( Romania ),

Dr. Tarvo Rajasalu ( Estonia ),

Prof. Urban Rosenqvist ( Sweden ),

Dr. Eric Senneville ( France ),

Dr. Fred Storms ( Netherlands ),

Prof.  Jan Vavrinec  ( Czech Republic ).

Do you have a weak heart? Move to Luxembourg if you want to get really good care! And get out of Romania as quick as you can!

Luxembourg treats hearts best according to the 2008 Euro Consumer Hearth Index, launched today in Brussels during a press conference hosted by the Health Consumer Powerhouse. There is a small group of countries that follow in this competition for excellence, separated only by some differences: France, Norway and Switzerland.

The Index compares 29 European cardiovascular healthcare systems in five categories, covering 28 performance indicators. The new Euro Consumer Heart Index conclusively demonstrates that effective prevention programs deliver a clear return on investment. Europe-wide gap is between guidelines for heart disease management; the realities of day to day clinical practice are also evident. Few countries have national screening programs and there is widespread under-use of medication, despite well accepted guidelines.

You can read the Recommendations for each country or go to the Media room to see the full Report, the Matrix and the Press releases.

TEMPORARY EMAIL PROBLEMS

As to confirm Murphy's laws, we are experiencing some problems with our server the day before the launch... therefore our email accounts do not function very well; for any urgent information please contact our Director for European Affairs, Ms. Kajsa Wilhelmsson, at +32496235530. Hopefully this problem will be solved as soon as possible.

Euro Consumer Heart Index 2008

On the 3rd of July we launch the Euro Consumer Heart Index 2008. You will find the report on our website by noon.

 

The new Index provides a ranking of cardiovascular healthcare systems in all the 27 European Union Member States, as well as Norway and Switzerland. Built with specific indicators, this Index assesses five key areas to the consumer: Information, consumer rights and choice, Access, Prevention, Procedures and Outcomes.

 

The Swedish Breast-Cancer Nurse of the Year

The new Swedish Novartis award “The breast cancer nurse of the year” was shared between Ms. Ingalill Koinberg and Ms. Gull-Britt Engholm and awarded for their contribution and dedication within the breast cancer care field. Together they have made a report on the follow-up of breast cancer surgery. They also produced a health economics study which will be available soon.

 

You can contact the two winners for more information:

Ingalill Koinberg, FOU/U-enheten, Sjukhuset i Varberg, +46-340-48 19 64, +46-709-35 03 86, ingalill.koinberg@lthalland.se

Gull-Britt Engholm, onkologimottagningen, Örebro Universitetssjukhus, +46-196-02 13 78, gullbritt.engholm@orebroll.se

The Health Consumer Powerhouse accepted as expert in the A.M.I. database of the European Comission

The Directorate-General for Health and Consumer Protection of the European Commission has accepted our request for insertion in their A.M.I. database of suppliers; the categories for which we were included as experts in project management and / or consumer policy are Health Information and Project Evaluation.

Response to the Open Consultation on Information to Patients

The European Commission launched in March an Open Consultation on Information to Patients. Click here to read our response.

EU Ambassador to the US uses HCP index

In his weekly newsletter John Bruton, the European Union ambassador to the US, elaborates on what the US can learn from Europe in the area of healthcare.

Euro Cardiovascular Healthcare Index 2008 July 3rd

Canada - an example of how healthcare should not be organized

Canada ranks 23rd for consumer friendliness in healthcare within the Euro-Canada Health Consumer Index 2008 report issued by the Swedish Health Consumer Powerhouse and the Canadian Frontier Centre for Public Policy. This is the first time that Canada is included in a comprehensive benchmarking among 29 national European healthcare systems. The comparison for Europe was published on the 1^st of October 2007.

"The Euro-Canada Health Consumer Index shows that Canada does a mediocre job in fulfilling our commitment to excellent and accessible healthcare" said Rebecca Wahlberg, the project's lead researcher. "The Austrians, the French and the Dutch enjoy better and more accessible healthcare than we do, and at a lower cost per capita. There is no reason why Canada cannot improve and reach a similar level."

Johan Hjertqvist, President of the Health Consumer Powerhouse, also notes that “A country that has long waiting times to cancer treatments plus slow deployment speed of new cancer drugs does not get good outcomes in cancer treatments. This is the case for Canada, as well as for Denmark, Portugal and Ireland, countries that should be able to do better.”

The overall conclusion of the report is that the Beveridge health care system in the UK and Canada is in need of serious structural reforms and not able to compete with the Bismarck inspired method of countries like Austria, Germany, the Netherlands or France.

The Swedish Vaccination 2007 Index

Pre-liminary report of the "WHO/European eHealth Consumer Trends Survey"

Authors: Hege K Andreassen, Tove Sørensen, Per Egil Kummervold

Publisher: Norwegian Centre for Telemedicine, University Hospital of North Norway

The report can be found here

There is little knowledge on how e-health will influence health care delivery. A survey on patients’ and health consumers’ use of e-health services is an opportunity to monitor to what degree e-health practices are becoming important in the everyday lives of European citizens. Further, the survey is a tool for policy makers when developing future health services.

The project includes two surveys, conducted with 18 months interval in seven European Countries, by interviewing health consumers by telephone. The countries were Norway, Denmark and Germany in Northern and Central Europe, Latvia and Poland in Eastern Europe and Greece and Portugal in Southern Europe.

The number of Internet health users increased from 44% in 2005 to 54% in 2007. The growth in the use of Internet for health purposes is found in all seven countries participating in the survey.  As expected, the Northern European countries are topping the list of active Internet health users. Denmark has the biggest population percentage using the Internet for healthcare related matters, 72% in 2007. Greece and Latvia have the most important growth between 2005 and 2007, 39% and 34% respectively. Thus the largest relative growth of Internet health users is found in Eastern and Southern Europe. This might indicate that the use of the Internet for health purposes becomes common in the general population.

Europe now has a three speed healthcare system

Austria is Europe’s most consumer-friendly healthcare system, according to the 2007 Euro Health Consumer Index (EHCI) launched today in Brussels at a press conference. A combination of widespread access to treatment and excellence in outcomes allowed Austria to narrowly pip the 2005 winners, the Netherlands, from the top spot. Last year’s winners France has slipped to 3rd place.

There is a small group of countries that compete for pre-eminence in excellence, separated only by minor differences. These are followed by a middle group of adequate performers and rapid improvers, with a rump of under-achievers. But no country in the index achieves more than 80% of their potential, and all remain in need of reform. The 2007 EHCI covers all 27 European Union members as well as Norway and Switzerland.

To read more:
The report EHCI 2007
The matrix EHCI 2007
The recommendations EHCI 2007
Press releases for all countries and a video presentation can be found in the media room

Health Consumer Powerhouse is urgently looking for a JUNIOR RESEARCHER

The Health Consumer Powerhouse aims to empower the healthcare consumer by offering benchmarking tools. We are now starting the work on a new disease related pan European index and we are looking for a junior researcher for this project.

Requirements:

Experience from healthcare is essential. Experience from the area of cardiovascular disease appreciated.

Fluent English – essential - any other languages an advantage.

Experience in dealing with governmental officials.

General: High level of communication and organisational skills; common sense,  ability to work under pressure and to respond independently, quickly and effectively to changing demands / tasks; good command of MS Office applications; able to work well in a team as well as independently.

We especially encourage people interested in collaboration contracts to apply since this is a time limited position.

To apply please send your CV to brussels@healthpowerhouse.com

Health Consumer Powerhouse is urgently looking for a COORDINATOR for its Brussels office

Requirements: Fluent English - other languages an advantage; high level of communication and organisational skills; common sense, initiative and time management skills; ability to deal with pressure and to respond quickly and effectively to changing demands / tasks; good command of MS Office applications; able to work independently and in a team.

To apply please send your CV to brussels@healthpowerhouse.com.

First Swedish Renal Care Index

The use of renal dialysis has increased substantially in Sweden since the early 70’s. This has contributed not only to an increased survival rate among patients suffering from renal insufficiency, but also to an improved quality of life.

Today, many patients can lead a fairly normal life, with significant influence on their own treatment. The medical technological development has made substantial progress, but – as this, the first Swedish renal care index shows – a lot remains to be done, in order to ensure individual patients reap the full benefits. Both counties and renal clinics have now to maximise the possibilities open to them to offer a consumer friendly renal care with a minimum of medical risks and inconveniences for the patient.

The renal care index 2007 shows how well the 21 counties manage to live up to current consumer demand for good renal care.

Information to patients

Health Consumer Powerhouse response to the High Level Pharmaceutical Forum consultation on information to patients. Please find our contribution Download file

World Health Day 2007 - high-level debate in Singapore

The World Health Day is celebrated every year on the 7th of April, the founding date of the World Health Organization (WHO). A high-level debate took place in Singapore on the 2nd of April this year, as the 7th of April not only fell on a Saturday but also on Easter.

This year's theme was international health security. These historically unprecedented globalisation and mobility that we are witnessing bring to the health field “universal vulnerability”, to quote from the speech of Dr. Margaret Chan, Director-General of the World Health Organization. “This creates a need for collective defences and for shared responsibility in making these defences work.” Speaking about this shared responsibility, Dr. Chan also underlined the importance of acting in pre-emptive way.
For the first time since its establishment, the WHO is authorized to act on media reports and use information other than official government notifications. Especially for matters of universal security, this is a significant step forward indeed.
Another important point made by Dr. Chan concerned the misuse of antimicrobials which causes drugs to fail much faster than the speed of replacing them, making antibiotics and other drugs no longer effective.

Last but not least, both Dr. Chan and Mr. Ban Ki-moon, the UN Secretary-General, spoke of investment in health as a keystone of economic growth and development. The issue is very important but they both approach it in a general and not quite convincing way. We all know there is investment in health, but how efficient is it? From this point of view a lot of things would be better understood if health was seen an economic growth in itself rather than a never-ending investment with the indirect meaning of expense.

These global security concerns are more developed in the WHO Issue paper "Invest in health, build a safer future". The main discussions presented here refer to emerging diseases such as avian influenza, international crisis and humanitarian emergencies, rapidly spreading diseases, the ongoing danger of bioterrorism, chemical spills or radioactive accidents, and the impact of HIV/AIDS. There are also two sub-chapters on environmental change and economic stability as strongly linked to and basis for a good global health protection.
The main conclusion of the paper is that we need to strengthen national and global preparedness and that capacity building should be based on the needs of the country, involving everyone, from governments to civil society and thus creating “a network of networks”. “The way to health is not through building national fortresses, but strengthening health systems globally.”

Unlocking Ideas

Ideas about health care get unlocked in a recently released book with the fitting name “Unlocking Ideas”.

Two members of the Health Consumer Powerhouse staff are among the contributing authors; the President of the company Johan Hjertqvist and the Director International Indexes, dr Arne Björnberg.

Health care services are often considered a cost problem. Dr Arne Björnberg, argues in his article that health care could instead become the largest service industry in society and a driver for growth in the economy. Ideas also presented in our The Great Paradigm Shift. The importance of transparency and access to information for the health consumer is highlighted in Johan Hjertqvist’s article.

Other contributing authors are the former president of the European Parliament Pat Cox, dr Jan Remans, rheumatologist and former member of the Belgian Senate and the deputy Minister of Health of the Czech Republic, Pavel Hrobon.

Experts’ conclusion: Transparency will improve cardiovascular care

The increasingly well-informed health consumer will have a big impact on healthcare, which is a development that should be embraced. This is one of the topics of the Madrid Declaration, published in the European Heart Journal, by 76 heart doctors and health care experts.

The Declaration makes clear that a public with better knowledge about cardiovascular diseases (CVD) will improve the quality of care. It also emphasises that this does not happen automatically. It requires access to good information to make change. In the immediate future, consumer-driven healthcare will be the rule in a society consisting of better informed citizens. Efforts to assess the values of preferences in the population regarding health and healthcare should be encouraged. To create reliable and stable Internet-sources of information to the public would be far better than the arbitrary coverage of different cures done by the media or promoted in advertisement towards the consumers. Medical guidelines are an important way to improve healthcare and the implementation of guidelines should be a benchmark tool for CVD clinics.

This message was part of the conclusion of an expert conference organized in June 2006 in Madrid by the European Society of Cardiology looking into European CVD care of the 21st century. Johan Hjertqvist lectured at this conference and contributed to the content of the declaration.

Health Consumer Powerhouse response to the European Commission consultation on the European Health Strategy

The European Commission has launched a consultation regarding the upcoming European Health Strategy. Health Consumer Powerhouse’s response to this consultation can be found here. Further information on developing a European health strategy is available on the European Commission website.

Response to European Commission Consultation regarding Community action on health services

In Europe, patient and care consumer mobility is starting to become a visible outcome of the European project: It offers the opportunity to access care not provided in your home country (or within a reasonable time frame). Likewise it improves choice to the consumer regarding providers and therapies. Mobility puts the healthcare systems under a healthy pressure to cope and deliver. Well-visited hospitals/service providers evidently have something to teach others. So there are lessons to learn from cross-border care. But reimbursement arrangements, outcomes measurement and systems transparency are key functions in modern consumer mobility markets and questions around these topics need answers.

The Commission aims at answer some of these questions by bringing forward proposals for Community action on health services. The first step is taken by consulting all stakeholders involved in the health services sector, on the basis of a specific consultation document. The Health Consumer Powerhouse (HCP) views the cross-border developments as positive and worthy of support so we appreciate having had the opportunity to take part in the European Commissions consultation on Health Services.

Please find our answer here.

Mr Johan Hjertqvist in the Wall Street Journal

Health Consumer Powerhouse's President, Mr Johan Hjertqvist, talks in the Wall Street Journal about Commissioners Kyprianou intention to create an internal market of health services and how this would relate with the competitiveness aspects of health care.

The Swedish breastcancer index was presented on November 30, 2006 at the National Swedish Medical Convention in Gothenburg

The first Swedish breastcancer care ranking reveals numerous consumer flaws

Every third Swedish county council does not follow the national recommendation to offer every woman between the ages of 40 and 74 a regular breast screening. As many counties require a GP referral to permit a visit to a breastcancer specialist. The 2006 Breastcancer Care Index reveals huge variations around Sweden in the use of Herceptin, a key life-saving therapy, and very different policies regarding how long you have to wait for the result of your screening.

The Index, for the first time measuring the consumer-friendliness of Swedish breastcancer care, is built from ten indicators comparing information, service and medical outcomes. The Index findings is a blow to the Swedish image of equity in care.

- Depending on where you live - or where you go for a diagnosis or treatment - your chances can differ a lot, concludes Oscar Hjertqvist, the Health Consumer Powerhouse index director Sweden. Some of the 21 counties offer you user-friendly procedures, others stay with the old protocol. The post-code lottery is not only a matter of access to new medication but also to good breast reconstruction practice and accessible tests.

- Nowhere in Sweden are there drop-in facilities offering screening without appointments and the result of the screening the same day. The single successful drop-in clinic now has chosen to restrict that possibility. Not a consumer-friendly policy, is Oscar Hjertqvists judgement.

The index was presented November 30, 2006 at the National Swedish Medical Convention in Gothenburg. The Index winners are the counties of Stockholm and Norrbotten, both scoring 13 out of potentially 16 points. The index average - 8,6 points - indicates though there is room for significant improvement in most counties!

You can find the English version here

More Care Index Attention to Dental Care

Dental care is an important health sector around Europe which might call for more consumer assessment and information. Lecturing Monday at the European forum for dentistry as a liberal profession in the European parliament Johan Hjertqvist indicated that the 2007 Euro Health Consumer Index might pay more attention to dental services. A potential indicator could be the share of the older population still carrying their natural teeth, the Health Consumer Powerhouse president suggested.

When forces are gathering to influence the process of the health service market directive the European dentists seem to favour a free market approach. This would be quite rational, as dentistry already is a frontrunner changing the perception of care services. "Health tourism" often is equal to combining affordable dental treatment with a holiday trip. Nowhere has competition, transparency and consumer influence grown this
strong.

Job Opportunity at Health Consumer Powerhouse

Health Consumer Powerhouse is looking for a freelance researcher with significant experience in the healthcare sector/industry. Please send your curriculum vitae, letter of intent with the list of publications and references to brussels@healthpowerhouse.com. For more information please contact Kajsa Wilhelmsson at kajsa.wilhelmsson@healthpowerhouse.com

Health Consumer Powerhouse at the Dutch Ministry of Health in Den Haag

House Consumer Powerhouse President Mr Johan Hjertqvist and Mr Arne Bjornberg will attend a high level meeting today with the Ministry of Health in Netherlands to discuss the impact of the 2006 EuroHealth Consumer Index on the Dutch health system.

Mr Johan Hjertquist in Financial Times

HCP's President, Mr Johan Hjertquist, talks in Financial Times about the advantages of patients mobility. He shows that: "Patient mobility puts the searchlight on discrepancies [in waiting times accross Europe], asking for better information on outcomes and the need for quality improvement".

Swedish elections landslide!

In a historic landslide Sweden turns to the market in healthcare as a centre-right government will take over. The new coalition promises to get rid of the Social Democrat ban on hospital privatisation. On the national level you can expect initiatives to deregulate the government pharmacy monopoly. Among the county councils and municipalities there will significant movements towards increased competition in healthcare and nursery care, with outsourcing, new contractors and entrepreneurs and incentives for internal market implementation. Reducing waiting times for care will be key to the new goverments on national and regional level.

I´ll be back with an election analysis.

Johan Hjertqvist
President

Swedish Diabetes Index 2006 presented today in Stockholm

The Swedish Diabetes index 2006, presented today in Stockholm, points to inequalities and weaknesses in Swedish diabetes care county by county.

Best care can be found in the counties of Blekinge and Östergötland. Three times as many diabetics have their feet amputated in the county of Gotland compared to Dalarna. Not one single county follows the National Board of Health and Welfare guidelines stipulating bi-annual eye check ups.

Based on the index outcome Health Consumer Powerhouse's conclusion suggests that counties start screening for diabetes as earlier detection lowers the risk for serious heart conditions and other side effects .

Diabetes index 2006, Score

Blekinge 14 points (out of 21 possible)
Östergötland 14
Dalarna 13
Örebro 13
Värmland 12
Gävleborg 12
Jämtland 11
Jönköping 11
Norrbotten 11
Halland 10
Västerbotten 10
Sörmland 9
Västra Götaland 9
Gotland 8
Kronoberg 8
Skåne 8
Stockholm 8
Uppsala 7
Kalmar 6
Västmanland 6
Västernorrland 2

Swedish diabetes patients can now use the site www.diabetesindex.se to email their county management and suggest concrete improvements of the diabetes care.

The full report can be found on the www.diabetesindex.se website. The index is built from 12 indicators. It will be further developed and updated during 2007-2008.
The report is made possible through an unrestricted research grant from Glaxo Smith Kline Sweden.

More than 73.000 downloads of the EHCI2006

Since the presentation of EuroHealth Consumer Index 2006 on
June 26 there has been more than 73.000 downloads of the report from this website!

To read the report:
EHCI 2006 Report (en)
EHCI 2006 Report (fr)

France—The winner of the 2006 Euro Health Consumer Index

France was announced as the most consumer-friendly healthcare system in Europe at a presentation in Brussels yesterday. It is the second year the European Health Consumer Index (EHCI) is presented. This year with an increased number of indicators covering all 25 member states health care systems including Switzerland. France won thanks to high level of access and service.

Read the full article here

New Ethical Code for Worldwide Pharmaceutical Marketing

Federation of Pharmaceutical Manufacturers & Associations (IFPMA) announced a couple of days ago in Madrid the new, updated Code of Pharmaceutical Marketing Practice. The updated code will be launched on 1 of January 2007.

The new updated code will combine the pharmaceutical marketing on a global level. Stronger and clearer guidelines worldwide regarding events, sponsorship and other types of pharmaceutical marketing will result in better benefits for the patient. IFPMA Director General Dr. Harvey E. Bale said:

“The revised Code, which enters into force in January 2007, reflects the global pharmaceutical industry’s commitment to ethical marketing practices that are intended to benefit patients and enhance the practice of medicine. The IFPMA Code is an important benchmark for the industry worldwide, because it applies to IFPMA members in all countries with no established local country Code. With clearer and stricter provisions in the new IFPMA Code, we will ensure that local code standards are strong and effective.”

Read IFPMA’s press release here

Improving the Healthcare Infrastructure for Sustainable Economic Growth

Listen to Health Consumer Powerhouse President Mr Johan Hjertqvist in an interesting panel discussion at the Horizon2020 Health conference.

Venue: Representation of the Free State of Bavaria to the European Union

Address: Rue Wiertz 77, 1000 Brussels

Date: Thursday, 22 June 2006

Time: 12:00 p.m. – 3.00 p.m.

Health expenditures in EU-15 reach 8.6% of GDP. In average 10% of the EU workforce are employed in healthcare. This makes healthcare an important economic factor and infrastructure component, significantly contributing to the wellbeing of people and to the economic growth of countries and regions. Therefore, instead of considering healthcare as a cost burden, healthcare’s full potential as a knowledge driven discipline must become the focus. Only then can healthcare play an important role in meeting the goals of the Lisbon Agenda.

What the herceptin breakthrough means

Last week the NHS gave up according to the BBC news. Every woman in England suffering from breast cancer will have the option of being treated with herceptin, the most efficient but expensive cancer cure. Herceptin has proved superior treating a certain kind of cancer which 15-20 percent of all breast cancer patient tend to suffer from.

Up till this change of policy herceptin medication was a kind of "post code lottery". Some NHS trusts provided herceptin (and a number of other, new medications) while others refused to pay for it. This inequality has been attacked by a militant opinions campaign led by breast cancer patients and relatives.

The NHS comment is that the costs for the new medication will mean cut backs in other parts of the budget. Less articulate patients will potentially suffer, is the message. In many countries you hear this kind of remarks:

Don´t rock the boat, wait for your turn, otherwise fellow-patients will be pushed away.

This kind of arguments reveals that the system is a slow learner. In an era of immediate access to information the system advocates expect mortally ill people to behave nicely and listen to budget reasons.

"Don´t count on having this new wonder drug - we ration it and in due time you will have a brown envelope in your post box telling you about our
decision. You might be dead by then but trust us that it will be well-balanced and fair".

No way people will tolerate this any more. A new era of consumer power is
dawning. There is an accelerating stream of new therapies. It is high time for the health care systems owners to make up their mind: rationing that kills people or radical reform to improve access to life-savers?

Johan Hjertqvist
President

What tools available help consumers to make more informed choices?

In response to the trend of increasing consumer involvement in health care decision making, Consumers in Health Care: Creating Decision-Support Tools That Work examines the various forms and functions of tools available to help consumers make more informed choices. It summarizes evidence regarding the effectiveness of these tools, and offers possible strategies for overcoming limitations to their widespread use.

Read the full report here

1.9 million die—many could still be alive

Every year 1.9 million EU inhabitants die from heart failure and other cardiovascular diseases. There are estimates that as much as half of these deadly incidents can be avoided.

What would people say if the knew that Uncle Edwin could still be alive having accessed good preventive care? Or that your mother might have left hospital recovered rather than dead if the emergency care procedures had been in accordance with modern guide lines?

This is the kind of questions I will raise in a couple of days, lecturing in Madrid. Cardiologists from around the world will be discussing the future of heart disease medical care. My theme at this European Conference on the Future of Cardiology will touch on how to empower the health care consumers by information. Here there are many sad stories to tell.

European consumers have the legal rights to move across national borders to pick the best care for their cardiovascular care. What keeps them back is especially the lack of information to build informed decisions regarding where to have a treatment. Here the European Society of Cardiology, hosts of the conference, has an important source of knowledge – but till now rather secretive about the findings. My provocative question will be: Isn’t it high time to offer the European health care consumers the full picture of outcomes allowing them to build own judgements? Wouldn’t consumer awareness about “post code lottery” behaviour and the options to take own action put a constructive pressure on European cardiovascular disease health care?

I will suggest a co-operation on developing a Cardiovascular Care Index of Europe, similar to what the Powerhouse already delivers. Such a comparison tool would open for a more stringent debate on how to improve care – not behind closed doors, but in dialogue with active, informed consumers. Learning that hundreds of thousands of people every year could survive a heart condition given appropriate care, consumers will ask for exactly such opening.

Johan Hjertqvist
President

Smaller practice – better health care?

Family physician L. Gordon Moore does everything as a big clinic except — it’s just him, a nurse and a computer. He is on call 24 h and sees most patients the day they call. This Is a totally new experience for many patients that are used to long waiting hours for appointments, errors and impersonal meetings.

Moore’s practice is one of many experiments by physicians in order to find a suitable system that the patient can trust.

Read the full article from USA Today here

Health consumer in focus

Swedish Health Consumer Index showed this year new factors and was a great success in media. Counties in Sweden do not have the same consumer friendly healthcare and the index shows the differences.

Read more at the Swedish Health consumer Index website

Another good day for healthcare consumers!

Today the European Court of Justice has ruled in favour of Mrs Yvonne Watts, UK, and her compatriots in care. The essence of the court decision seems to be (when it comes to the ECJ you must read also between the lines) like this: EU citizens waiting for a medical procedure
can go abroad to have a reimbursable treatment, regarding “undue delay” in their home country.

Mrs Watts, 74, was first told to wait one year for a hip replacement. Displaying her anger the NHS offered to cut the wait till 3-4 months. But she went to France anyhow, paying herself for the treatment and then charging the NHS for the costs. Now the Court declares that she should have a refund but seems unwilling to specify what are the acceptable limits for waiting. UK courts have better look into the waiting times making national judgements, the ECJ suggests.

The ruling of today is another step in the direction of consumer power in health care. As three-four months of waiting now look unacceptable in a pan-European perspective a number of EU member care systems might need to shape up. The argument that good and timely services would cost too much does not carry, says the decision. I.e. what is good for the NHS – and other national systems – might be unacceptable to the consumer…

Mrs Watts found a suitable French clinic on her own. Most consumers look for improved information to take such a big step. Help is eventually under way though. Not by the European Commission the Health Portal of which has spent large resources to build an empty frame, exposed last week when the Portal was launched. No, it takes far more to empower the consumers to make informed choices in health care. Today, for the third consecutive year we presented our Swedish Health Consumer Index, providing comparative data on health care. As Swedish media will be displaying the next few days also in egalitarian Sweden it is important to look for the best care offers. It is a matter of service levels, quality outcomes and access. Especially as in Sweden you can buy a bottle of vodka on a Saturday but never see you doctor …

Johan Hjertqvist
President

Another tough pill to swallow

Yesterdays´ local elections in the UK took place in the shadow of not only governmental scandals but the ongoing NHS reforms as well. On of many paths to improvement concerns access to care outside of office hours. This is a typical matter for monopolistic health care systems like in the UK or Sweden, unheard of in continental Europe where family doctors make home calls when you need them.

The shake-up of the out of hours health care system in England is "shambolic" and has led to longer waits and higher costs, a committee of MPs now states, according to BBC Health.

Chairman of the public accounts committee Edward Leigh said: "The new way of providing out-of-hours medical care has so far been a costly mess that has left many sick people waiting too long for help."

The NHS Local Trusts has tried to contract providers to take on out of hour’s tasks. New providers are spending 22% more but are not meeting key targets, the public accounts committee claimed. The outcomes? Fewer than 10% of primary care trusts meet targets on assessing patients within 20 minutes of an urgent call. Not very promising…

Contracting care providers is far from easy. Experience from large scale contracting processes, like in the Greater Stockholm County, reveal that success takes much more fantasy, imagination and consumer-style thinking than public purchasing bodies are able to deliver. It tends to be only too much of copying the last tender offer and established routines. First class providers are seldom rewarded and poor ones can stay in business far too long. So the NHS problems are neither new nor surprising.

Well, so the answer is to get rid of competition and a multitude of providers, returning to the safe, monopolistic tradition? Absolutely not – on the contrary! But what it takes is not public intermediaries “translating” the “needs” of the population but ways to allow consumers to express their demand and make own choices. Here we talk of voucher systems, private insurance or saving account models ensuring the individual purchasing power.

Empowering the consumer is different from empowering public bureaucracy! The tough pill to swallow is that old medicine does not work and only radical steps will ensure real change!

Johan Hjertqvist
President

Hospital heart surgery survival rates are being published for the first time in England and Whales

The Healthcare Commission has produced a website listing performance for 30 of the 33 hospitals with heart units. The website are listing details of survival rates for all cardiac surgery and also individually for the two most common types of heart surgery.

“This is an important move in increasing information available to patients and the public about clinical outcomes” said Sir Ian Kennedy, Healthcare Commission chairman.

Patients in England and Whales demanded more openness after surgeons where found to have continued carrying out heart operations even though they had higher death rates than in other hospitals.

Read the full article from BBC news here

Fast track to patient safety

In Britain about 10% of inpatient episodes result in errors, of which about half are preventable, according to research from the National Patient Safety Agency (NPSA). A lack of bedside checks, a high rate of missing wristbands and a tendency for staff not to ask patients their name before they receive blood all contribute to misidentification, and can result in the wrong treatment.

Mix-ups in patient identity happen all too often, leading Birmingham Heartlands hospital to install a state-of-the-art patient tracking system on one of its wards.

Read the full article from The Guardian here

Recruitment to our Brussels office

Health Consumer Powerhouse is recruiting to our Brussels office:

One position as researcher and one part time Assistant (flexible hours and possibility to work partly from home)

We looking for practical problem solving capacity, result oriented approach and excellent computer skills. A fluent French is needed for the assistant position. English is our working language. Candidates must be able to start out as Independent. It’s a value driven company so candidates must share our basic views.

Applications (incl financial expectations) and questions to kajsa.Wilhelmsson@healthpowerhouse.com.

Killing inequality

Equality in health care is looked upon as a European value. It sounds good but in real life - and death – the conditions for prevention, treatment and survival shift strongly around the European Union:

• Waiting times for critical procedures like cancer treatment varies. In two out of three EU member countries you must wait more than thee weeks to have a treatment.
• The survival rate among breast cancer or heart infarct patients relates to which country you live in, and to a large extent is not dependent on what healthcare resources different member states can afford (i.e. level of national wealth). Breast cancer champions are the Netherlands, Poland, Spain and Sweden while infarct patient in average have the best odds in the UK, the Netherlands and Sweden.
• Still key procedures too often are implemented at random. In some countries and hospitals 90 percent of the patients suffering from cardiovascular diseases and a high blood pressure are put on beta blockers while maybe just in the next city only half of them get this kind of medication. Statins to reduce the harmful blood lipids are becoming more common but again what in many clinics is standard procedure is rare in others. Regular eye screening to control diabetes is another guideline actively implemented by many hospitals but meeting resistance among others.

Looking into these examples the problem is hardly the lack of guidelines or insights of what is the best medicine. What it takes is rather a critical mass regarding media coverage and patient/consumer action enough to make the prize for systems negligence too high.

A good example of how to highlight critical needs was the Women´s at Heart conference in Brussels the other week. Here the European Heart Network and the European Society of Cardiology called upon the Council of Ministers to adopt a EU recommendation on a concrete EU-wide cardiovascular strategy including health promotion, support of the member states strategies and activities and guidelines on risk assessment, optimal preventive methods, treatment, rehabilitation and screening. As cardiovascular diseases prematurely kill two million EU citizens every year the gravity of the problem is hard to argue about.

What you might add to the shopping list is better evaluation of medical outcomes – key to improvement but where the European Commission for some perverse reasons still prefer to talk about resource input. Survival rates vs. the number of bed-days – judge yourself which data is of concern to you…

Johan Hjertqvist
President

Measuring European Health Care for consumers

Was it possible to provide consumer-friendly information about health care? And if so how could we develop a useful tool to collect and compare the data?

That was two questions Health Consumer Powerhouse had when started in 2003. Read Oscar Hjertqvist, project manager of Swedish Health consumer Index full cover story at Fraser forum on the experiences of developing measures to compare Swedish and European health care for the consumers. Read the article here

The need for watchdogs

The recent tragic events in UK where the testing of a new drug caused life-threatening side effects is an extreme case. There are few if any parallels. The risk is that the focus turns to this kind of anomalies from the even more serious need among care consumers to have good information on pharmaceuticals and medical procedures.

In the EuroHealth Consumer Index (EHCI) 2006 (to be launched in Brussels June 26) we will point to the need for governments to support the position of consumers. We discuss how to measure such ambitions. “Is there a patient ombudsman” linked to the national health care system taking raking rapid action? “Are patient organizations involved in healthcare policy decision making” might be another criteria if you want to compare the EU care systems.

Looking into information about pharmaceuticals European consumers would gain from better access. Today the EU is caught in a dilemma between on one hand the want to improve information to make people more competent dealing with their illness and on the other the fear of an “American situation”. I.e. direct to consumer marketing. A first step on the road of constructive compromise would be introduction of a layman-adapted pharmacopeia in every country. Such a tool, readily accessible to the public, would strengthen the muscles of the consumers. We would like to bring this element into the EHCI 2006.

By no means such action is enough. Not until you make this kind of pharmacopeia consumer-driven you will take a big step forward. Here you can open a link for consumer-driven reports of daily life side-effects of the kind seldom channelled by the medical profession. According to expert authorities like the NICE in UK and the European Medicines Agency (EMEA) on the Union level there is a large flow of unwanted symptoms which never surface.

So, if you want to see the whole of the under-information iceberg you better improve the consumer communication on pharmaceuticals. This should not be such a provoking thing, should it?

Johan Hjertqvist
President

Shop and compare hospital care

The Dallas Morning News reports a growing number of hospitals in the US that reports care quality measures online open for the care consumer.

One of the most popular websites is Medicares (health insurance program for the elderly and disabled in the USA) that show how well 4 200 hospitals are doing in different treatments such as treating heart attacks, pneumonia or preventing surgical infections.

"indiviual consumers will be deciding where to go for surgery, and they´ll be looking at hospital infection rates" sais Adonica Benesh, director of hospital quality improvement at the TMF Healh Quality Insitute in Austin.

Read the full article here (free subscription)

Medical errors in European Health Care

European citizens doesn’t feel protected from medical errors and the health care isn’t as safe as it should be according to the Eurobarameters servey on medical errors that was launched in February 2006 survey .

Read the full report here

Mobility between health care systems- catalyst for change

Consumer mobility in health care, also known as "health care tourism" are growing. When the volume reaches a critical mass the pressure grows and most likely will effect the quality of health care in the right direction.

Mr Johan Hjertqvist, president Health consumer powerhouse, bloggs at CNE Health website. Read the full blogg here

Patients want to be treated like customers

Clarian, Indianapolis's largest health care provider has to aid consumers in their decisions launched the Clarian Quality web site

"It is Clarian's goal to improve patient care in Indianapolis, across Indiana and beyond, by an increased focus on continuous quality improvement," says Sam Flanders, senior vice president of medical quality for Clarian.

The quality site is grouped in nine categories:

- Volume (number of procedures)
- Patient safety
- Patient satisfaction
- Heart and Vascular
- Transplant (survival and wait times)
- ICU
- Diabetes
- General medicine
- Primary care

Read the full text here

Increased demand for 2006 winner of the HealthConsumer Index

2005 years winner of the Swedish HealthConsumer Index, the county council Kalmar, meets with Oscar Hjertqvist, director of the consumer index, to learn more about the new increased demands for 2006 years version of the Index.

Read more in the article from Östra Småland here

The EuroHealth Consumer Index 2006 International Expert Group

The EuroHealth Consumer Index 2006 expert group had its initial meeting February 2 in Brussels.

The aim was to look into the present index design discussing how to develop the index design and indicators. In the meeting took part Laura Aiuppa, director special projects at the National Committe for Quality Assurance (NCQA), Washington DC, dr Katrin Grueber, head of the Institut Mensch, Ethik unde Wissenschaft (IMEW) in Berlin, professor of psychiatry Meni Malliori, Athens, and Caroline Powell, deputy chief executive at the Picker Institute Europe, Oxford.

The EuroHealth Consumer Index 2006 will be presented June 26 in Brussels.

President Bush addresses the need for health care policy reform in his State of the Union speech Jan 31

"Keeping America competitive requires affordable health care. (Applause.) Our government has a responsibility to provide health care for the poor and the elderly, and we are meeting that responsibility. (Applause.) For all Americans -- for all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship, and help people afford the insurance coverage they need. (Applause.)"

"We will make wider use of electronic records and other health information technology, to help control costs and reduce dangerous medical errors. We will strengthen health savings accounts -- making sure individuals and small business employees can buy insurance with the same advantages that people working for big businesses now get. (Applause.) We will do more to make this coverage portable, so workers can switch jobs without having to worry about losing their health insurance. (Applause.) And because lawsuits are driving many good doctors out of practice -- leaving women in nearly 1,500 American counties without a single OB/GYN -- I ask the Congress to pass medical liability reform this year. (Applause.)"

Direct quote from the State of the Union address Jan 31.

JH

President
Health Consumer Powerhouse
Brussels/Stockholm
www.healthpowerhouse.com

4000 patients die because of wrong treatment in Sweden

Each year almost 4000 patients die because of unnecessary mistakes in the Swedish health care system do to maltreatment, accidents and information failure.

Health consumer powerhouse has fore some years put the patient safety in focus and welcomes this discussion in Swedish media. The Swedish patient safety is no better than in any other country. In smaller studies around Sweden it seemed even worse than what we thought said the director-general of the national board of health and welfare, Kjell Asplund, to the Swedish daily Svenska Dagbladet.

Read the full text article in Swedish here.

Life Saver For Drowning Health System In Germany

In Germany doctors take to the streets opposing the conditions in health care.The frustration among the doctors reflects the transformation that is at hand around Europe. Governments try to limit the cost growth by attacking the reimbursement of the service providers - for given services as well as for the equipment doctors and other providers buy.

In Johan Hjertqvist blog at CNE Health he describes the problem and how a private health insurance system can be the life saver for Germany’s drowning health system.

New website with facts about the global health

GlobalHealthFacts.org, a project of the Henry J. Kaiser Family Foundation, provides free, up-to-date and easy-to-access data by country on HIV/AIDS, tuberculosis, malaria and other key health and socio-economic indicators.

The data are displayed in tables, charts, and color-coded maps and can be downloaded for custom analyses. View the webpage here

Balance between Safety, Efficiency needed in E-prescribing

Finding a balance between safety and efficiency concerns is essential to getting physicians to utilize electronic prescribing systems, according to a new report in the Journal of the American Medical Informatics Association, Modern Healthcare reports. Read the full text article here.

Six steps to improve quality in hospitals

Hospitals do more mistakes than health care consumers are aware of. The Institute of Medicine shocked the American nation with a report on hospital errors in 1999. The reports conclusion was that up to 98,000 Americans died each year – not because of the disease but from injuries caused by their medical care from the hospital.

It is actually the small changes that trigger the tipping point and therefore important to track them down which The Institute for Healthcare Improvement have done. The institute has identified six basic prevention measures that could save as many as 100,000 lives per year. To do so they need 2,000 hospitals who would adopt the prevention steps. Today, almost 3,000 American hospitals have sign up and are a part of the campaign to improve the quality of care. The six prevention steps are as follow:

1. Activate a Rapid Response Team at the first sign that a patient’s condition is worsening and by taking the signals seriously the team can call for backup and respond within minutes.

2. Prevent patients from dying of heart attacks by delivering evidence-based care, including appropriate administration when the patient arrives with aspirin to prevent blood clots and Beta blockers to prevent further heart attacks.

3. Prevent medication errors by “up date” the medication every time the patients move from one place to another which should be checked and rechecked by a nurse or doctor.

4. Prevent patients that have catheters that deliver food and medicine intravenously from infections by including proper hand washing, simple procedures for changing bandages around the catheter and changing the catheter or take it out if not needed.

5. Prevent patients undergoing surgery from developing infections by following a series of preventive steps like giving the right amount of antibiotics during surgery, strictly hand-washing and not shaving the surgery site before the operation.

6. Prevent patients from respirator pneumonia by following a few simple steps like raising the patients head and frequently cleaning the patient’s mouth.

This campaign encourages hospitals to actually prevent mistakes that they before wanted to hide which is something we could learn from in European health care.

The full version of the Newsweek article by Donald M. Berwick, M.D can be read here

Right information technology, wrong health information

In a recent US survey patients were shown to in first hand turn to the Internet when seeking health information, not their physicians.

However, the survey also showed that the health consumers still trust the informatione they get from their physician more than the information on the Internet.

Mr. Bradford W. Hesse and his associates published in the Archives of Internal Medicine point out in their report that:

"The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage". Read the full article here.

The growth of information technology in the health care sector makes consumer based health information more directly available, and changes how the information is presented.

Joshua Seidman Ph .D, Center for Information Teherapy Washington D.C, says:
“For example, a diabetic patient accessing his personal health record may find that a recent hemoglobin A1c test is 10 percent, but what does the patient do with that information? Are there ways to help patients understand the data—and the actions they should take—without having to schedule a visit with a provider? Are there ways of ensuring that an Internet search could supply patients with meaningful information?”

Are there ways for the consumer to understand the data without having to schedule a visit with a provider? Read the full report here.

Change is Coming - Health Policy Matters

Grace-Marie Turner from the Galen Institute reports from The Consumer Directed Health Care Conference that is being held this week in Washington.

Steve Case, founder and former chairman of AOL Time Warner, held an interesting speech assuring attendees that:

"A consumer revolution in health care is coming. The critics can't stop it,the naysayers can't deny it. The question isn't an 'if' - it's a question of 'when' and 'how.'"

Steve Case describes four trends that is propelling the movement:

1. A shift in cost of health care from employers to consumers - coming much faster than was imagined a few years ago, and accelerating more each year.
2. A demand for more efficiency, cost-savings and convenience in health care - a demand that comes increasingly from patients themselves, as they do more of the paying.
3. A desire for more information about health care choices, and more tools and services to manage health care.
4. A desire to live longer, healthier, more active lives, fueled by a greater awareness of the role of prevention and wellness in enabling such a future.

Read Grace-Marie Turner full report from the Conference at www.galen.org/ownins.asp?docID=851.

A storm from nowhere

What are the similarities between the Canadian healthcare system
today and being struck in an airport due to snowstorms? Johan Hjertqvist explains this on CNE Health.

Consumer driven Vs Provider driven health care- why not a blend of both?

In James C. Robinson new article he examines the different forms of organizations and different forms of payment for care. Robinson conclusion is that rather than offering mismatched solutions to the same problem, consumerism and managed competition can be complementary, offering different solutions to different problems.

Read the full text here.

A new report on Health Care as a Driver of Growth

In Dr Arne Björnbergs new report he challange todays discussion about health care costs. The report demonstrate that healthcare services can be converted from being an increasingly difficult cost problem into becoming the largest service industry in society. Read the full report here.

Mementos from Canada

During his tour in Canada and the US Johan Hjertqvist spoke at the Frontier Center, partcipiated in the Canadian television program "Adler on Global" and talk radio. To see the television program online - klick here.

More Health Care Is Not Necessarily Better Health Care

The Medicare system pays some California hospitals four times more than others to care for patients with similar chronic illnesses, with no gain in quality or patient satisfaction, according to a study by the Center for the Evaluative Clinical Sciences at Dartmouth Medical School. The study reveals that average spending per patient varied by a factor of four among hospitals in the state. The additional care provided in some regions and hospitals did not improve medical outcomes or patient satisfaction; in fact, as the volume of care increased, the quality of care and patient satisfaction declined. The study also found that improved hospital efficiency could have saved Medicare $1.7 billion over five years in Los Angeles alone. Read more about the study here

Can Canada learn anything from European health care systems?

November 11 Johan Hjertqvist lectures in Vancouver, Canada, at the Saving Medicare conference.

Together with other international reform expert Mr Johan Hjertqvist, President of the Health Consumer Powerhouse in Brussels is invited to feed ideas and experience into the intense debate on how to improve the Canadian health care system. A well known policy former in Canada Johan will focus on European health care experience from the consumer point of view.

You can read about the conference and his lecture here

Patients voice - The policy leaders window to better health care

The current issue of Health Affairs reports on a survey on sicker adults in Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States.

Sizable shares of patients in all six countries report safety risks, poor care coordination, and deficiencies in care for chronic conditions. Majorities in all countries report that mistakes occurred outside the hospital.

The United States often stands out for inefficient care and errors and is an outlier on access/cost barriers. Yet no country consistently leads or lags across survey domains. Deficiencies in transition care during hospital discharge and coordination failures among patients seeing multiple physicians underscore shared challenges of improving performance across sites of care.

Invitation to "The Great Paradigm Shift" in Brussels

The Stockholm Network's Amigo Society and Health Consumer Powerhouse invite you to discuss

The Great Paradigm Shift:
Health Care as a Driver of Growth

Featuring

Dr. Arne Björnberg
Former Head
Swedish National Pharmacy Corporation

Opponent:

Sonja Teughels
Advisor Knowledge Center
Voka - Flanders Chamber of Commerce and Industry

"What is driving health care demand? What to do with an ageing society? How can we ensure a "fair" distribution of dwindling health budgets? How do we administer shortages?" These issues erroneously dominate the current debate and present health care as a "cost" to society and a problem for decision-makers. Rather than focussing on budget cuts or rationing, this event will demonstrate why the cost control paradigm is a fallacy and reveal why health care has the potential of becoming the largest service industry in our societies.

Tuesday 22 November, 2005
6:30 for 7:00pm - 8.30pm
Hotel Amigo, rue de l'Amigo, 1-3, Brussels, Belgium

RSVP: Terry O'Dwyer
T: +44 20 7354 9006,
F: +44 20 7349 8888
Acceptances Only Please
terry@stockholm-network.org

Sustainable Financing of Healthcare in Europe

That one-day invitation-only conference was held in Luxemburg on October 27, 2005. As on many other healthcare conferences, a lot was said about controlling standards, containing costs, medical & technical innovation and patient empowerment, particularly by using the Internet.

Sadly, through the event ran the Ariadne thread of top-down controlling of healthcare provision. "It is imperative that we see to that only the right healthcare is provided strictly to those patients who need it."

If I believe that I would really like to see my doctor today - why should anybody else, particularly a bureaucrat or politician, tell me otherwise? As was mentioned several times during the conference as a major problem: "The demand for healthcare services is endless!" But just what is the problem with that?

In healthcare, we have a very qualified, knowledge- and research-intensive service industry, which cannot be moved to India or China. Like most other service industries, provision has to be where the customers are; in or near their homes!

As usual on a European event, mentioning American healthcare systems immediately provokes the reaction that: "There are 50 million Americans, who do not have access to good healthcare!" This is certainly true, and to the thinking man would inspire the thought "then let us not copy American social insurance ideology!"

On the other hand, largely due to the American attitude to healthcare as a consumer service industry, there are 250 million Americans who do receive excellent quality healthcare when and where they want it. With the exception of General Motors' sickness benefits managers (the Americans most closely resembling European healthcare administrators), this is not a cost problem. Healthcare is a gigantic service industry, contributing to Gross National Income - not dragging the GNI down.

What if there would be a "third alternative" for European healthcare? Not containing it, not raising taxes to increase its funding, but stimulating healthcare provision in excess of what is provided for by public systems to become a consumer service industry?

The Lisbon agenda deals with the seemingly eternal problem of U.S. economy outperforming that of the EU. Small wonder - precisely those service industries, which form the base of American economic growth, are being treated as cost problems in the EU, and thereby blocked out from and blocking EU economic growth.

A key component needs to be inserted in the system: open and transparent selection criteria when doctors do the sorting between problems, that warrant public healthcare services and problems which do not.

The "endless demand" for healthcare could then be the basis for a fantastic European service industry. "Ladies and Gentlemen - I give you EUR 200 billion of additional economic growth!"

Your life may hang on your postcode

Due to the differences between hospitals and doctors in medical treatment your life may one day hang on your postcode. Is it between 112 and 115 - congratualtions, you'll get the new and efficient medicine. If not - well, the doctors will do their best ...

Johan Hjertqvist blogs about this subject on CNE Health.

Health Consumer Powerhouse launches new magazine

On Wednesday 12/10 Health Consumer Powerhouse launches Din Vård (Your Health Care), Sweden's first magazine for health consumers.

The first issue covers topics such as:

- Mothers-to-be as active health consumers.
- Is the health care service level good enough where you live - we have the figures!
- Health information on the Internet.
- How Swedish health consumers can access health care in other European countries.

The magazine is distributed together with Svenska Dagbladet, the second largest Swedish daily newspaper. Din Vård will have a quarterly print-run of 182 000 copies.

Health Consumer Powerhouse lanserar vårdkonsumenttidning

På onsdagen tolfte oktober lanserar Health Consumer Powerhouse Din Vård, Sveriges första tidning för vårdkonsumenter.

Den första utgåvan tar upp ämnen som:

- Blivande mödrar som aktiva vårdskonsumenter
- Är landstingets servicenivå god nog för dig - vi har siffrorna!
- Sjukvårdsinformation på Internet
- Hur kan svenska vårdkonsumenter söka sjukvård i andra europeiska länder.

Tidningen distribueras med Svenska Dagbladet i en upplaga på 182 000 exemplar.

High stakes in the Hague

This week the the Health Consumer Powerhouse met with the Minister of Health Hans Hoogervorst to describe the EuroHealth Consumer Index to him and his staff (the Netherlands turning out the 2005 champion).

Read more at Johan Hjertqvist's blog at CNE Health.

Johan Hjertqvist bloggs at CNE Health

Read more about "Listening to the People" in the UK here .

Powerhouse speaker on Prioritization in Healthcare

On the 3rd National Conference on Prioritization in Healthcare, Gothenburg September 23, Dr. Arne Björnberg will be giving a presentation on "Open Prioritization - Newspeak for Rationing Healthcare, or a Key Element for Solving the Economic Growth Problems of the Nation?"

Open and transparent priorities are key to opening up healthcare for alternative ways of financing care for less severe conditions. In public healthcare systems, such problems tend to be not catered for or waitlisted for long periods.

Healthcare as a consumer industry has the potential to contribute very significantly to European economic growth. GDP growth generated by the Healthcare industry alone could amount to 1 - 2% P.A.

Index presentation to the health minister of the Netherlands

October 5 the Health Consumer Powerhouse is invited to the Hague to present the EuroHealth Consumer Index 2005 to mr Hans Hoogervorst, the Dutch minister of health, and his staff.

XV Economic Forum

At the XV Economic Forum in Krynica Polen The HealthConsumerPowerhouse President Johan Hjertqvist made introduction remarks at the presentation of the book Poles apart. His remarks where on the topic "The European health care consumer".
Read the presentationt

UK presidency: making patient mobility a key health topic

The UK will take over the rotating presidency of the European Union July 1. Ahead of this change a senior diplomat recently held a health policy briefing at Brussels think tank The Centre .

He outlined that the UK’s ambitions for the six-month period included issues such as the fight against HIV/AIDS, food additives, self certification and patient mobility, which he said would be one of the UK’s main priorities.

“A substantial amount of research has been done on the subject of patient mobility by high level groups in the European Commission and the Council of Ministers,” he said. “I believe the UK presidency will move this issue along in the next few months.”

The diplomat added that he thought there would be a “very big debate on patient mobility. The issue is being driven by decisions at the European Court of Justice arising from the single market and also the Lisbon agenda.”

The Commission is also keen to promote the idea as it has appointed Roger Madelin, director general of DG Sanco head of the high level group. “Their work has contributed a good, solid background that has added value to the patient mobility debate.”

The diplomat also said that ideas where crystallizing about when Europe should co-operate on health issues. “In all our discussions we are tripping over this type of debate and as I said before it is a very big debate.”

The diplomat acknowledged the work done in the European Parliament on the issue, particularly that of MEP John Bowis, but was less certain on how far the issue could be promoted legally by the UK presidency.

Media Comments EHCI

European media on the Index

“Mediocre results for the Belgian healthcare”, is the headline of the Belgian newspaper la Derniere Heure reporting on the EuroHealth Consumer Index 2005. In the news coverage this daily points to the indicator displaying that Belgian consumers today have direct access to a specialist. That might change, says DH, as the Belgian government wants to give economic incentives to people contracting a gatekeeper GP. It is promising, finds this paper, that the Index will be updated annually to cover changes to come among the health care systems.

Also the Flemish-speaking Belgian paper Het Nieuwsblad reports on the outcomes putting Belgium in the fourth row together with Estonia and Sweden.

In Netherlands – the Index winner – the Reformatorisch Dagblad reports “Top scores for Netherland care”. In the opposite outcomes end the leading Italian daily la Repubblica finds:”Healthcare: Italy next to bottom regarding consumer focus”, finding that though some positive outcomes there seem to be a number of weak spots in the Italian health care.

The Times in UK finds that “Britain´s mediocre healthcare does poorly”, expressing some excitement of the Index giving UK good scores for its policy on pharmaceuticals (subsidy rate and speed of licensed drugs entering the reimbursement system).

In Sweden two big dailies provide editorial comments on the Index. The Expressen finds that Swedish health care is technically advanced (4th re medical outcomes) but far too bureaucratic to meet the demand. And the Svenska Dagbladet draws similar conclusions: “We can be proud of the medical outcomes…but together with UK we have the longest waiting lines”.

The Reuters Health Information gives a lengthy description of the Index outcomes based on an interview with dr Arne Bjornberg, the Powerhouse Index manager. Also the BBC Health News reports on “UK health ranked ninth in Europe”, adding a comment from a spokeswoman for the UK´s department of Health. Not surprisingly this government source seeks comfort (thinking of the rating of NHS waiting lists and killer bug infection risk) in the request for typical top-down indicators, like the OECD life expectancy figures. Such statistics though say very little of the daily care quality offered to the consumer, which is the main idea behind our Index.

The Ministry of Health in the Hague is more pleased. In a statement the minister Hans Hoogervorst finds the Index a good initiative, increasing the transparency of health care to the gain of the citizens.

The Netherlands Top in Healthcare: Meets consumer expectations best

Health Consumer Powerhouse launched the new EuroHealth Consumer Index in Brussels at the Health Consumer Summit 2005. The Index ranks national health care systems across 20 indicators, covering five areas – patients’ rights and information, waiting times for common treatments, care outcomes, customer friendliness and access to medication. The Index takes a consumer-centred position, excluding conventional public health indicators such as hospital beds and life expectancy from its perspective.

The index benchmarked 12 national healthcare systems in Europe. Out of a potential 60 points the Netherlands gained 48, positioning its health care as the most consumer-friendly. In second and third places respectively were Switzerland (47 points) and Germany (46). In 12th place was Poland with 25 points. Perennial top performers France and Sweden, often hailed as model healthcare systems by international rankings, only achieve mid-table positions.

Johan Hjertqvist, President of Health Consumer Powerhouse, commented “With health consumer mobility growing around Europe, there is a strong need for transparency exposing the pros and cons of the national healthcare systems. If you want to go abroad for a treatment you need to know what you can expect in waiting times, level of services, risk of hospital infections and access to new drugs. For the first time there is a ranking tool for consumers providing answers to this kind of questions.”

“This is only our first step”, stated Johan Hjertqvist. “Assuming this approach is favourably received, we want to rank all 25 EU countries next year. We need to inspire the creation of improved methods of displaying the healthcare standards in Europe, responding to declarations from the European Commission, the European Parliament, patients’ organisations and care industry. It is high time to take the health consumer seriously!”

Launch of the EuroHealth Consumer Index

Around 100 guests visited the launch in Brussels of the EuroHealth Consumer Index 2005, including health experts, patient organisations and representatives from many of the countries in the index.

Johan Hjertqvist, president and founder of HCP, began with a vision of the near future. A Europe where half of the population has a chronic disease, vaccinations against nicotine are possible and millions of “snowbirds” in the Mediterranean won’t have the same kind of healthcare system as today. Mr Hjertqvist predicted that this shift wouldn’t come through a big reform, but through many small changes.

Dr. Arne Björnberg introduced the Index and illuminated the dramatic differences between the 12 healthcare systems. Waiting times for treatment were almost non-existent in countries as France, Belgium and Switzerland while they were a major problem in countries as Sweden and Great Britain.

One impressive feat was the reform speed of Estonia. In just 14 years the country has transformed from a Soviet commando system to a modern consumer-driven healthcare system.

After the summit, the Index was also thoroughly covered in most of the press in the countries included.

European Health Consumer Index

The European Health Consumer Index is being presented in Brussels at the Health Consumer Summit. The materials from the Summit can be found in our Media Room

Revolution in Canada

Yesterday the Supreme Court of Canada ruled aginst the national health system, a cornerstone of Canadian identity.

This system prohibits private insurance when public services are already available. But in reality the public access is poor, found the Court, causing long waiting times and other problems. Formally the verdict affects conditions only in the Quebec province but as there are similar waiting times in numerous other provinces the whole public system is now under heavy fire. Read more at the website of Frontier Center, a partner of the Powerhouse.

The Swedish Health Consumer Index: Impact on media, policy discussion

A high degree of activity after our launch 2005 shows that the councils now are starting to view The Swedish Health Consumer Index as quite important. The reasoning behind the ranking system is starting to register on the mental radar of the county councils. The consumer point of view on healthcare can not longer be ignored by politicians, civil servants or media.

In April 2004, when the Swedish Health Consumer Index (SHCI) was first published, the Index had a huge coverage in media – but was in many ways treated primarily a curiosity. Few county councils (there are 21 of these tax-funded regional governments around Sweden, responsible for funding and generally also providing care services) commented on the Index ranking outcomes. The Swedish Association for County Councils (SALAR) dismissed the whole reasoning behind SHCI. Typically the individual council reports on SHCI was limited to statements like “Our county council is the third best in Sweden”.

Though a wide-spread impact (assessed as 82 daily paper clippings and radio/TV news items) with some exceptions the SHCI disappeared from the news coverage within a week. This was what we expected; when an independent think tank introduces an unconventional, challenging new perspective and assessment tool it would be far too much to count on a general acceptance and sustained debate already in the first year.

After the 2004 launch Swedish patient organisations have been using the Index outcomes and documentation for discussions with their elected politicians and county council managers. Some politicians have argued that their councils should implement the SHCI approach and indicators to better evaluate and benchmark the public health care system. We recently noticed that a county council mentioned scoring a good mark in the SHCI 2004 in the annual report evidently putting high value to this information. This kind of daily impact though has not yet attracted attention from media or national politics.

When presented in May the SHCI 2005 got a somewhat different treatment. The “ordinary” news coverage was excellent (est. 120 media hits in the first 48 hrs, incl. the three big national TV news rooms). The regional media paid a lot of attention to the outcomes regarding their council. But adding to this impact several news articles elaborated on the Index themes, i.e. the lack of information for health consumers, the discrepancy between cost and quality in Swedish healthcare and that healthcare in every county, no matter the ranking in the index, suffers from a serious lack of access.

The opinion that county councils and healthcare provision can be measured and compared is this year far more accepted among journalists and politicians than in the first year. In several media hits the SHCI is compared to international surveys of healthcare and the attitudes among health consumers. We judge that the Index idea of comparing outcomes now is well established. Furthermore media in a striking way accept the Index focus and parameters, highlighting consumer access and service. “Consumer-designed health care” is becoming a common phrase (seldom used before 2004).

The SALAR comment on the 2005 Index: “Open comparisons between county councils, hospitals and primary health care centres stimulate the patient influence as well as the development of the healthcare”
Ms. Ellen Hyttsten, the head of the SALAR healthcare department.

We can see that SHCI is used as an argument in discussions about healthcare policy and quality. Either does the political opposition in the county council criticise the services provided based on results from SHCI or does the majority in power points to a potentially favourable ranking as evidence of the high quality. When heavy-weight councillors of the Social Democrat or Left Party refers to the Index debating centre-right opponents it is a clear sign that SHCI no longer is looked upon as a free market whim but a part of reality. In the winning county – Kalmar – the centre-left parliamentarians furiously attack the centre-right majority for relying on the Index outcomes – while in a neighbourhood council (Östergötland, in bronze position) the Social Democrat government publicly announce that the good ranking proves the excellent performance by the regional health care system….

In 2005 you find many examples of how the county councils comment on the Index on their websites and they are generally positive. One out of three councils quickly presented such comments. We notice that this time they were well prepared to meet media alerts (we have a dialogue with each council regarding the background figures). Most web site comments stress that this kind of comparisons are important and that today’s healthcare does not pay enough attention to the consumer perspective. Most interesting: some county councils now declare they work hard to meet the EHCI requirements, improving conditions regarding information, service or access to treatments. “We must not stay in a bottom position” or “In the next years Index we will be positioned over average” are the kind of statements you easily find. Getting a low score is bad PR, gaining a good one is a reward. Logically many of the bad performers now announce action: programs for better access, new information policies, own consumer surveys to learn more and so on.

Far more county councils got in touch with the Powerhouse after the 2005 launch than in 2004 claiming better points in the Index. They could not prove their claims but the higher degree of activity shows that the councils view the SHCI ranking as quite important. The reasoning behind the ranking system is starting to register on the mental radar of the county councils

A few quotes from the cou