Study reveals differences in health performance among new EU members 

The study highlights the fact that the new Member States are far from being homogeneous which also results in variations in health status in these countries. The historical, economic, political and social context is different in the two Mediterranean newcomers, Cyprus and Malta, and the eight Central and Eastern European (CEE) countries: Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia (which was not part of the Soviet bloc). There are obvious differences also within the CEE group.

Life expectancy in Cyprus and Malta is very similar to the EU average, while life expectancy in the CEE countries is below that of the old Member States. In Cyprus, the prevalence of respiratory diseases is high due to high levels of tobacco consumption and obesity. In the CEECs, the study highlights that the economic transition has particularly hit poorly-educated men. As a result, gender differences in life expectancy are as wide as nine years in some cases. On the whole, in the CEE countries, there is a higher prevalence of cardiovascular disease, road traffic accidents and cancers (notably lung and cervical cancer). This is the result of a difference in lifestyle, notably diets high in saturated fats, smoking habits and alcohol consumption.

Health systems in the CEE countries have undergone a major change from a highly centralised structure funded from state revenue to a different system capable of functioning in a market economy. The two new sources of funding which have emerged are social health insurance contributions and out of pocket payments (user charges and informal payments). However, the study concludes that substantial gains in health system performance were not achieved for a number of reasons, including a failure to reform the provision of healthcare (eg. supply, organisation and reimbursement of hospitals), continuing over-capacity, as well as the distorting effects of informal payments to healthcare providers. Decentralisation has in many cases led to the transfer of revenue collection to regional structures, which has resulted in inequities between regions.

Overall, the experts conclude that the health gap between the EU-15 and the eight CEE new members is narrowing. As to the longer-term impact of EU accession on the healthcare systems of the new members, the study points out that EU legislation will be useful in addressing health inequalities. In the internal market, however, tobacco and alcoholic beverages travel free, just like health professionals. It is as yet unclear whether the new members will be in favour of increasing the role of the EU in the domain of public health.