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How resilient is health financing policy in Europe to economic shocks? Evidence from the first year of the COVID-19 pandemic and the 2008 global financial crisis

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  • Thomson, Sarah
  • García-Ramírez, Jorge Alejandro
  • Akkazieva, Baktygul
  • Habicht, Triin
  • Cylus, Jonathan
  • Evetovits, Tamás

Abstract

The COVID-19 pandemic triggered an economic shock just ten years after the shock of the 2008 global financial crisis. Economic shocks are a challenge for health systems because they reduce government revenue at the same time as they increase the need for publicly financed health care. This article explores the resilience of health financing policy to economic shocks by reviewing policy responses to the financial crisis and COVID-19 in Europe. It finds that some health systems were weakened by responses to the 2008 crisis. Responses to the pandemic show evidence of lessons learnt from the earlier crisis but also reveal weaknesses in health financing policy that limit national preparedness to face economic shocks, particularly in countries with social health insurance schemes. These weaknesses highlight where permanent changes are needed to strengthen resilience in future: countries will have to find ways to reduce cyclicality in coverage policy and revenue-raising; increase the priority given to health in allocating public spending; and ensure that resources are used to meet equity and efficiency goals. Although many health systems are likely to face budgetary pressure in the years ahead, the experience of the 2008 crisis shows that austerity is not an option because it undermines resilience and progress towards universal health coverage.

Suggested Citation

  • Thomson, Sarah & García-Ramírez, Jorge Alejandro & Akkazieva, Baktygul & Habicht, Triin & Cylus, Jonathan & Evetovits, Tamás, 2022. "How resilient is health financing policy in Europe to economic shocks? Evidence from the first year of the COVID-19 pandemic and the 2008 global financial crisis," Health Policy, Elsevier, vol. 126(1), pages 7-15.
  • Handle: RePEc:eee:hepoli:v:126:y:2022:i:1:p:7-15
    DOI: 10.1016/j.healthpol.2021.11.002
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    References listed on IDEAS

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    1. Peter R Orszag & Robert E Rubin & Joseph E Stiglitz, 2022. "Fiscal resiliency in a deeply uncertain world: The role of semiautonomous discretion [Revisiting the Federal Budget Outlook]," Industrial and Corporate Change, Oxford University Press and the Associazione ICC, vol. 31(2), pages 281-300.
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    Cited by:

    1. Halyna Mishchuk & Jakub Jerzy Czarkowski & Anastasiia Neverkovets & Eszter Lukács, 2023. "Ensuring Sustainable Development in Light of Pandemic “New Normal” Influence," Sustainability, MDPI, vol. 15(18), pages 1-16, September.
    2. Laura Otero-García & José Tomás Mateos & Alexo Esperato & Laia Llubes-Arrià & Vanesa Regulez-Campo & Carles Muntaner & Helena Legido-Quigley, 2023. "Austerity Measures and Underfunding of the Spanish Health System during the COVID-19 Pandemic—Perception of Healthcare Staff in Spain," IJERPH, MDPI, vol. 20(3), pages 1-10, January.

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