EUR/RC62/wd08 (Eng) - WHO/Europe - World Health Organization

EUR/RC62/8
page 20
and effectively to translate genome-based knowledge and technologies into public health: this is
a major task of public health genomics and an important area of potential innovation in Europe.
Health policies should prepare to meet this future vision of medicine and health. This means
that, instead of solely focusing on the biological determinants of health or emphasizing mainly
social determinants, health will need to be approached through the perspective of all its
determinants, including biological, lifestyle, environmental and social factors and the
interactions between them. In the future, public health genomics will probably provide the
vision and tools to integrate genome-based information (as a part of the biological determinants
of health) into health care systems and policies.
92. Such technologically based innovations have already created new opportunities to
improve health and health care. These changes substantially affect aggregate health care costs,
especially when numerous organizational and professional factors support their use. This is
illustrated by the dramatic increases in health care costs in the last years of life. To the extent
that technology enables newer or better treatments, greater spending may involve increasing the
level of health care purchased rather than unnecessary or wasted cost. Some technologies, such
as the self-measurement of blood glucose, may have an upfront cost but reduce expenses related
to complications further down the road.
93. Whether a particular new technology will increase or decrease health expenditure
depends on several factors. How does it affect the cost of treating an individual person? How
many times is the new technology used? On what basis can its use be rationed? Does the new
technology extend existing treatments to new conditions? Does the technology cost more
immediately but lead to later savings? New technologies may extend life expectancy, affecting
both the type and amount of health care that people use in their lifetime. The real balance of
costs and savings can often only be evaluated by long-term epidemiological and health
economic studies.
The macroeconomics of health and well-being
Health – a key factor in productivity, economic development and growth
94. Health 2020 addresses the economic and funding aspects of health and health systems.
Social progress and stability have been achieved most successfully in countries that ensure the
availability of services promoting good health and education, and of effective social safety nets,
through strong public services and sustainable public finances. Failure to achieve these goals
can be reflected in a decline in societies’ social capital of civic institutions and social networks.
95. Health is increasingly acknowledged as significantly affecting both the economic
dimensions of a society and its social cohesion. The macroeconomics of health and well-being
therefore need to be better understood. In the past 30 years, the health sector has shifted from
being a functional sector focused on, and investing mainly in, health care services to
constituting a major economic force in its own right. Today health is one of the world’s largest
and most rapidly growing industries, associated with more than 10% of the gross domestic
product of most high-income countries and about 10% of their workforce. It encompasses a
wide range of business sectors, services, manufacturers and suppliers, ranging from the local to
the global. During the recent economic recession, the continual growth of the health care
industry was a stabilizing factor in many countries. Nevertheless, its output and output
efficiency clearly deserve to be maximized.
96. In some countries, increases in health care costs are difficult to manage and can put
countries and industries at a competitive disadvantage. Health funding has therefore moved to
the fore of the health debate, exploring new ways of raising revenue for health and moving
away from exclusive reliance on labour-related direct taxes. These are especially relevant in