EPHA welcomes the presence of a stronger social dimension as part of the Annual Growth Survey 2017. The AGS is a key document launching the European Semester process, a yearly cycle of economic policy coordination, each year. The AGS sets out general economic and social priorities for the EU and provides policy guidance for member states for the following year.
The call for promoting social investment more broadly, including in healthcare, childcare, housing support and rehabilitation services is a key element in the AGS. From a Health in All Policies (HiAP) standpoint, there is a clear opportunity for health benefits in all of the areas mentioned. At the same time, EU countries hit hardest by the crisis still suffer from a lack of social investments and are subject to stricter fiscal surveillance. While more flexibilities to combine various forms of EU funding to support social investments as suggested in the AGS is a step in the right direction, the Commission should also consider a readjustment of the rules governing the Stability and Growth Pact (SGP) to promote investments in more EU member states.
The 2017 AGS puts a clear emphasis on cost/effectiveness of health care and long-term care systems, but also maintains focus on adequate access including focus on primary care services while mentioning the importance of health promotion and disease prevention. While the document puts a clear focus on inclusive labour markets, it does not mention that employment is substantially impacted by prevalence of chronic conditions. The OECD Health at a Glance Europe 2016 Report states that
Greater efforts are needed to prevent chronic diseases among the working-age population, and better integration is needed between health and labour market policies to reduce the detrimental labour market impacts of ill-health, and thus contribute to better lives and more inclusive economies.
In fact, premature deaths from non-communicable chronic diseases (NCDs) strongly correlate with below average health investments and the degree of out-of-pocket payments, with considerable variation across EU member states. Despite clear evidence illustrating the scale of the problem, its social and economic costs, the NCD burden remains worryingly under-prioritised in EU policy frameworks. Currently, the AGS as well as the accompanying Joint Employment Report (JER) consider access to health and long-term care, as well as self-reported unmet health needs as important indicators. EPHA would welcome this approach to be complemented by the involvement of health outcome measures and targets aiming to reduce the burden of NCDs. This can prove helpful for future programming and utilization of Structural and Investment Funds (ESIF) and the European Fund for Strategic Investments (EFSI). In order reduce health disparities across Europe and contribute to more inclusive labour markets, there is an urgent need to go beyond a mere best practice exchange in the area of NCDs and direct health investments where they are most needed.