EDITORIALS |
The Health Society: Importance of the new policy proposal by the EU Commission on Health and Consumer Affairs
As health expands in modern societies, the role of the citizen in health gains increasing importance. This role has many facets: as an individual who takes care of her own health, as a consumer in the health market place, as a patient in the health care system, as a voter on health care issues, and as a social activist or volunteer together with others in Non Governmental Organizations and social movements.
In this context, the access to knowledge and information plays an ever-larger role in managing health and disease. Health systems and health plans are becoming more complex to navigate, treatment options need to be considered, complex drug regimes need to be adhered to, living wills need to be drawn up, and healthy lifestyles need to be lived. Every visit to the supermarket demands health choices, every decision to take the car rather than walk has health consequences. Indeed, both living in health and living with disease demand high health literacy, reflexivity and constant decision making not only within the medical system but within the context of every day life.
A NEW POLICY APPROACH IN THE EUROPEAN UNION
In April 2005 plans were launched for a new European Union Programme, which aims to ‘exploit the synergies between two policy areas which are central to the concerns of European Citizens’. (Press release EIS 06/04/2005
). The new Health Commissioner Markos Kyprianou received approval from his fellow commissioners for a combined Health and Consumer Protection Strategy 2007–2013 and this document will now be passed on to the Council of Ministers and to the European Parliament. The communication from the Commission is entitled ‘Healthier, safer, more confident citizens’ and brings together the Public Health and Consumer protection policies and programmes under one common framework. It has three joint core objectives:
- To protect citizens from risks and threats, which are beyond the control of individuals and cannot be effectively tackled by member states alone (e.g. health threats, unsafe products, unfair commercial practices).
- To enhance the ability of citizens to take better decisions about their health and consumer interest.
- To mainstream health and consumer policy objectives across all EU policies in order to put health and consumer issues at the center of policy-making.
). THE HEALTH SOCIETY
The expansion of health into every aspect of everyday life and politics and as an essential component of the market and household expenditure is captured with the term ‘health society’. While matters of health, health care and disease are increasingly dominant in the political discourse, in general we see a retreat of the state from public health and health care provision. Instead, the main driving force is a new mix between the role of the citizen/consumer/patient, advances in medicine and biotechnology and the expanding private market in health and health services.
There are six defining characteristics of the health society:
- A radical shift in demographics, a high life and healthy life expectancy and an increasingly ageing population
- an expansive health and medical care system that takes up increasing parts of the GNP and of personal income
- an expanding health market for information, products and services both alongside (for example wellness) and within the medical system
- the increasing prominence of health in the debate about political and social priorities, about rights and responsibilities
- the increasing importance of health as a major personal goal in life
- and finally the right to health as a key component of modern citizenship.
The Commission paper makes explicit reference to ‘the challenges posed to all consumers by more complex and sophisticated modern markets, that allow more choice, but also bring greater risks including crime’ (Commission, 2005, page 8). The health society creates a new landscape of paradoxes for reform in health: it leads to greater consumer involvement and empowerment but also to increasing privatization of health care and increasing inequities in health, it marries personal health goals and the drive towards autonomy with the consumer market which offers an increasing number of wellness products and services (Kickbusch and Payne, 2003).
The Commission paper clearly maps actions that need to be taken in relation to consumer protection in the Internal Market by ‘ensuring a common high level of protection for all EU consumers, wherever they live, travel to or buy from in the EU, from risks and threats to their safety and economic interests’. (Commission, 2005, page 9) This includes:
- better understanding of consumers and markets,
- better consumer protection regulation,
- better enforcement, monitoring and redress and
- better-informed and educated consumers.
THE MOVE TOWARDS COMBINED HEALTH AND CONSUMER POLICIES
The health society constitutes a new environment, which calls for new types of health policies at national, European and global level. They will need:
- to take into account the continuous processes of individualization and differentiation—but not through increased delegation to the individual, the family the community but through the expansion of their empowerment and choices, their rights and general health literacy;
- to recognize the increasing presence of health in the market place—as a product and promise—and ensure consumer safety as well as counteract the exclusion of those with no buying power;
- to respond to the increasing health inequalities within and between countries, also in the most developed countries of the world; and
- to recognize that the divisions between different systems of health action and policy (promotion, prevention, treatment, disease management, care) are becoming increasingly blurred and need to be integrated.
The EU policy proposal is a breakthrough that understands this connection. May national policies follow—and may public health advocates argue clearly why, in the face of the tobacco, alcohol and obesity epidemics, healthy public policies are necessary in the market place of goods and services. Such policies must first and foremost aim to empower consumers in ways we have not considered before.
REFERENCE
Kickbusch I. and Payne L. (2003) 21st century health promotion: the public health revolution meets the wellness revolution. Health Promotion International 18, 275–278.
Commission of the European Communities. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of Regions. Healthier, safer, more confident citizens: a Health and Consumer protection Strategy. Proposal for a decision of the European Parliament and of the Council establishing a programme of Community action in the field of Health and Consumer Protection 2007–2013. Brussels 6.4.2005, COM (2005) final EN.
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