Document A6465/14/14 Ag 13.3 New Health-care PPP..? Working Group on Article 64 and Article 65 of the Staff Regulations Meeting in Luxembourg 24th & 25th March 2014

Current approach to healthcare PPP Source: ECP The problem: different delivery systems in MS Full payment by consumer at point of purchase Part payment by consumer, balance paid by government or private insurer Full payment by government or private insurer Part payment by government, balance paid by private insurer → Potential impact for price collection

How resolved in ECP at present? Output approach: Consumer price survey (eg. 2011-2) on three year rolling cycle collects market price (and also asks subsidised price) for medical goods and some medical services. Inbetween, updated with HICP. Input approach: Supplementary survey of "Compensation of government employees" collects medical salaries, intermediate consumption costs. A64 Just uses consumer price survey data

How resolved in A64 at present? Just uses consumer price survey data Single basic heading for "healthcare" covering all sub-groups (pharmaceutical products, other medical goods, outpatient services, hospital care) with both "private" (full market) price and "public" (subsidised) price. → Always able to calculate a parity with Brussels, even if for some countries it is based on fewer item comparisons than is the case for others → Quality might improve if able to extend coverage somehow

New ECP approach A specific survey of hospital costs Defined sample of representative hospitals covering defined model cases Pilot calculations 2010-2012. Decision to apply with effect from 2013.

New ECP approach: results Q: should these hospital PPP figures be integrated for A64 purposes?

JSIS database Reimbursement of staff medical claims Already analysed for internal management purposes Findings can be made available to ESTAT Similar groupings

JSIS database vs ECP survey Consultations Medical services Hospitalisation and surgery - Dental care and treatments Dental services Various treatments Paramedical services Orthopaedic devices Therapeutic appliances and eqpt. Other medical products Pharmaceutical products

JSIS coefficients d'égalité Q: should these coefficients be integrated for A64 purposes to fill gaps?