1. 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

2. 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

3. How resolved in ECP at present?
Output approach: Consumer price survey (eg ) 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

4. 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

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

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

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

8. 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

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