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Country profiles of health system responses to the crisis | Czech Republic 365 • The health insurance funds, backed by the Ministry of Health, proposed that in 2013 they would not renew contracts with 12 inpatient providers (2012). These 12 providers would be transformed into long-term care facilities (and hence acute beds transformed into long-term care beds). • The Ministry of Health issued a call for proposals on e-health planning (2012). Priority setting or protocols to change access to treatments, coordination of care and patterns of use • Governmental decree defined obligations for health insurance funds to contract and secure access and maximum waiting times (2013). • Centralization of specialized care (transplants, oncology, cardiology, brain injury) across several tiers of care with a referral system. Waiting times • A governmental decree established maximum waiting times for planned medical procedures and maximum distances (average time taken to drive) to facilities (2013). Health promotion and prevention • Large reductions made to the National Institute of Public Health budget, but these were compensated by public awareness campaigns financed by the European Fund for Regional Development (2010, 2011, 2012).
Denmark Andreas Rudkjøbing and Karsten Vrangbæk Economic trends • Real per capita GDP in Denmark contracted in 2009 but returned to positive growth in 2010; however, the economy was sluggish in 2011. Before the crisis the government had run a budget surplus, but there have been repeated years of deficit from 2009 to 2011. Government spending as a share of GDP is consistently the highest in Europe, while 10-year bond rates have dropped and are among the lowest in Europe. • Health spending forms a significant portion of government spending and the government is the primary source of funding; per capita growth slowed from 8.6% in 2009 to 2.0% in 2010 (Denmark: Fig. 1). • Denmark Fig 2 gives the trends in per capita spending on health. Policy responses Changes to public funding for the health system • In 2009, budgets were exceeded across the public sector. • The government pledged to allocate an extra DKK 5 billion to the health sector in 2011–2013 (2010), enabling continued growth in regional public spending on health care, which rose from 67% of total spending on health in 2007 to 75% in 2011, while total spending on health declined in 2010 and 2011. • Tax relief for corporate purchase of VHI was abolished (2011). • A budget law limited the government's structural deficit to 0.5% of GDP and established binding expenditure ceilings, effective from 2014, for state, regions and municipalities, although the ceilings exclude unemployment benefits, cash benefits and public investments (2012). • Taxes on saturated fat and sugars introduced in 2011 (not earmarked for health) were abolished because of increasing cross-border trade with (especially) Germany, which limited their effect on public health (2013). Changes to health coverage Population (entitlement) • No response reported.
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Economic crisis, health systems and
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The European Observatory on Health
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Keywords: DELIVERY OF HEALTH CARE E
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vi Economic crisis, health systems
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viii Economic crisis, health system
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List of abbreviations ACS Health in
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List of tables and figures Tables P
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xiv Economic crisis, health systems
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xvi Economic crisis, health systems
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xviii Economic crisis, health syste
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xxii Economic crisis, health system
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xxvi Economic crisis, health system
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Acknowledgements This book represen
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Preface This book maps health polic
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Part I Country case studies
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4 Economic crisis, health systems a
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10 Economic crisis, health systems
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Chapter 4 The impact of the crisis
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Chapter 4 | The impact of the crisi
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Page 356 and 357: Albania Genc Burazeri and Enver Ros
Page 358 and 359: Country profiles of health system r
Page 362 and 363: Austria Thomas Czypionka and Maria
Page 366 and 367: Azerbaijan Fuad Ibrahimov Economic
Page 382 and 383: Bulgaria Antoniya Dimova and Mina P
Page 390 and 391: Cyprus Elisavet Constantinou and Ma
Page 394 and 395: Czech Republic Tomáš Roubal and J
Page 404 and 405: Estonia Triin Habicht and Mall Lein
Page 408 and 409: Finland Jan Klavus and Lauri Vuoren
Page 412 and 413: France Karine Chevreul, Karen Berg
Page 420 and 421: Germany Klaus-Dirk Henke and Wilm Q
Page 434 and 435: Iceland Sigrún Gunnarsdóttir and
Page 438 and 439: Ireland Anne Nolan and Steve Thomas
Page 444 and 445: Israel Bruce Rosen and Amir Shmueli
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Country profiles of health system r
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Kazakhstan Ninel Kadyrova and Tata
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Latvia Uldis Mitenbergs and Maris T
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Malta Natasha Azzopardi Muscat Econ
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Montenegro Ratka Knežević Economi
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Norway Anne Karin Lindahl and Jon M
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The Russian Federation Elena Potapc
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Serbia Vukasin Radulovic Economic t
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Spain Enrique Bernal-Delgado, Sandr
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Switzerland Alberto Holly and Phili
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Tajikistan Ghafur Khodjamurodov Eco
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Ukraine Valeria Lekhan and Mariia T
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