Global Aging Issues
AARP European Leadership Study
Research Report
December 2006
Summary
AARP Board of Directors and executive leadership conducted the European Leadership Study in June 2006 to gain a deeper understanding and knowledge of the European experience on health and long-term care. The Study highlighted practical policies, model programs and best practices in the United Kingdom, France, Norway and the Netherlands. AARP Global Aging Program and Public Policy Institute have since released four papers providing comparative research and analysis on health and long-term care issues.
Prescription Drug Pricing
Health Information Technology
Long-Term Care
European Experiences with Health Care Cost Containment
The rapidly increasing cost of health care, driven by new technologies and treatments, and increasing utilization is a challenge that virtually all industrialized societies are struggling to combat. This report describes key trends, cost containment issues and approaches being used, and policies that influence health care spending and system sustainability in the U.S. and four European countries—France, the Netherlands, Norway, and the United Kingdom. The report also identifies some lessons learned from the experiences of these countries in attempting to contain health care costs.
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European Experiences with Prescription Drug Pricing
Do Americans spend more on prescription drugs than residents of other countries and, if so, why? Over the years, this has been a topic of much debate and study, particularly with regard to the price of individual drug products. If the United States adopted policies from other advanced countries, would the pattern of drug spending change? The following report describes key policies, market forces, and trends that influence prescription drug spending in the United States and three European countries—France, Norway, and the United Kingdom. The report also identifies some lessons learned from the experiences of these countries in attempting to control the cost of pharmaceuticals, especially through the regulation of prescription drug prices.
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European Experiences with Health Information Technology
With a few notable exceptions, such as the Department of Veterans Affairs in the public sector and large integrated HMOs like Kaiser Health Plans in the private sector, United States adoption of HIT lags considerably behind most European countries. Some estimate that the U.S. is behind between 4 and 13 years in implementing a national initiative compared to those nations with more mature national HIT systems. Finland, the Netherlands, Sweden, Denmark, and the United Kingdom are considered the leading users of HIT. Nevertheless, in view of its primary purpose as an enabling tool to improve health care quality, the full power of HIT has not yet been realized, even in those countries where HIT adoption is more advanced. For example, electronic clinical information systems cannot consistently track patients across care settings or multiple providers—a function that is critical to better care coordination, improved quality, as well as performance assessment.
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European Experiences with Long-Term Care
The United States does not have a comprehensive long-term care system. Arguably, it has no system at all. Medicare does not cover long-term care services. Private long-term care insurance remains expensive and not available to everyone. Americans rely primarily upon the unpaid contributions of family members and friends, who provide the vast majority of LTC services received by people of all ages who need help with basic daily activities. Medicaid, a safety net program and payer of last resort designed for people with low incomes and few assets, is the primary public financing system for LTC, with benefits varying from state to state. European perspectives on LTC are a largely untapped resource for examining ways to improve the financing and delivery of LTC in the U.S. Virtually all European countries have had far higher proportions of people age 80 and older than the U.S. has had for some time. Some of these countries have implemented LTC programs that hold important lessons for the U.S. and can serve as “natural laboratories” for tracking the impact of LTC policy changes over time. This paper concentrates on describing the LTC systems in the Netherlands, Norway and, to a lesser extent, the United Kingdom and France.
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