European Quarterly of the European Observatory on Health Systems and Policies EUROHEALTHon Health Systems and Policies RESEARCH • DEBATE • POLICY • NEWS Observatory 20th Anniversary Special Issue • 20 years of evidence into practice • What's new in health system › 2018 Observatory reforms • Happy Birthday Observatory | • Successes and failures of public 20th Anniversary • The role of health systems in the health policy 21st century Special Issue • Universal coverage and evidence- Number 2 • Evolution of health system performance | based approaches assessment • Reframing the health workforce • EU integration and health policy at the cross-roads :: Special Issue :: Volume 24 EUROHEALTH Quarterly of the European Observatory on Health Systems and Policies Eurostation (Office 07C020) List of Contributing Observatory Place Victor Horta / Victor Hortaplein, 40 / 10 1060 Brussels, Belgium Staff and Associated Collaborators T: +32 2 524 9240 Miriam Blümel w Berlin University of Wilm Quentin w Berlin University of F: +32 2 525 0936 Technology; and European Observatory on Technology; and European Observatory on Email: [email protected] Health Systems and Policies, Germany Health Systems and Policies, Germany http://www.healthobservatory.eu Reinhard Busse w Berlin University of Bernd Rechel w European Observatory on Health Technology; and European Observatory on Systems and Policies, United Kingdom SENIOR EDITORIAL TEAM Health Systems and Policies, Germany Sherry Merkur: +44 20 7955 6194 [email protected] Erica Richardson w European Observatory on Jonathan Cylus w European Observatory on Health Systems and Policies, United Kingdom Anna Maresso: [email protected] Health Systems and Policies, United Kingdom David McDaid: +44 20 7955 6381 [email protected] Anna Sagan w European Observatory on Health Irene Glinos w European Observatory on Systems and Policies, United Kingdom EDITORIAL ADVISOR Health Systems and Policies, Belgium Peter C Smith w Imperial College Business School Willy Palm: [email protected] Josep Figueras w European Observatory on and University of York, United Kingdom Health Systems and Policies, Belgium FOUNDING EDITOR Richard B Saltman w Rollins School of Elias Mossialos: [email protected] Cristina Hernández-Quevedo w European Observatory Public Health, Emory University, USA on Health Systems and Policies, United Kingdom Anne Spranger w Berlin University of LSE Health, London School of Economics Marina Karanikolos w European Observatory on Technology; and European Observatory on and Political Science Health Systems and Policies, United Kingdom Health Systems and Policies, Germany Houghton Street, London WC2A 2AE, United Kingdom T: +44 20 7955 6840 Suszy Lessof w European Observatory on Ewout van Ginneken w European Observatory F: +44 20 7955 6803 Health Systems and Policies, Belgium on Health Systems and Policies, Germany http://www2.lse.ac.uk/LSEHealthAndSocialCare/ Claudia Maier w Berlin University of Liisa-Maria Voipio-Pulkki w Ministry of aboutUs/LSEHealth/home.aspx Technology; and European Observatory on Social Affairs and Health, Finland Health Systems and Policies, Germany Gemma A Williams w European Observatory on EDITORIAL ADVISORY BOARD Anna Maresso w European Observatory on Health Systems and Policies, United Kingdom Paul Belcher, Reinhard Busse, Josep Figueras, Health Systems and Policies, Germany Julian Le Grand, Willy Palm, Suszy Lessof, Martin McKee, Juliane Winkelmann w Berlin University of Elias Mossialos, Richard B. Saltman, Sarah Thomson David McDaid w The London School of Economics Technology; and European Observatory on & Political Science; and European Observatory on Health Systems and Policies, Germany Health Systems and Policies, United Kingdom DESIGN EDITOR Matthias Wismar w European Observatory Steve Still: [email protected] Martin McKee w London School of Hygiene & on Health Systems and Policies, Belgium Tropical Medicine; and European Observatory on PRODUCTION MANAGER Health Systems and Policies, United Kingdom Jonathan North: [email protected] CONTENTS Sherry Merkur w European Observatory on SUBSCRIPTIONS MANAGER Health Systems and Policies, United Kingdom Caroline White: [email protected] Elias Mossialos w The London School of Economics & Political Science; and European Observatory on Article Submission Guidelines Health Systems and Policies, United Kingdom Available at: http://tinyurl.com/eurohealth Willy Palm w European Observatory on Health Systems and Policies, Belgium Eurohealth is a quarterly publication that provides a forum for researchers, experts and policymakers to express Dimitra Panteli w Berlin University of their views on health policy issues and so contribute Technology; and European Observatory on to a constructive debate in Europe and beyond. Health Systems and Policies, Germany The views expressed in Eurohealth are those of the authors alone and not necessarily those of the European Observatory on Health Systems and Policies or any of its partners or sponsors. Articles are independently commissioned by the editors or submitted by authors for consideration. Observatory publication & administrative staff The European Observatory on Health Systems and Policies Nuria Armingau w Assistant to Director is a partnership between the World Health Organization Celine Demaret w Assistant Regional Office for Europe, the Governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, Annalisa Marianecci w Programme Assistant Switzerland, the United Kingdom and the Veneto Region of Jonathan North w Publications Officer Italy, the European Commission, the World Bank, UNCAM (French National Union of Health Insurance Funds), Shirley Popoola w Financial Administrator London School of Economics and Political Science and Ahamed Tijjani Remawa w Administrative Officer the London School of Hygiene & Tropical Medicine. Cristina Ribeiro Russo w Financial Administrator © WHO on behalf of European Observatory on Health Maurizio Uddo w IT Officer Systems and Policies 2018. No part of this publication Caroline White w Publications Assistant may be copied, reproduced, stored in a retrieval system or transmitted in any form without prior permission. Design and Production: Steve Still Eurohealth is available online at: http://www.euro.who.int/en/about-us/partners/observatory/publications/eurohealth and in hard-copy format. If you want to be alerted when a new publication goes online, please sign up to the Observatory e-bulletin: ISSN 1356 – 1030 http://www.euro.who.int/en/home/projects/observatory/publications/e-bulletins To subscribe to receive hard copies of Eurohealth, please send your request and contact details to: [email protected] Back issues of Eurohealth are available at: http://www.lse.ac.uk/lsehealthandsocialcare/publications/eurohealth/eurohealth.aspx 1 EDITORIAL – OBSERVATORY 20TH ANNIVERSARY: TWENTY YEARS OF EVIDENCE 2 INTO PRACTICE – Josep Figueras and Liisa-Maria Voipio-Pulkki Eurohealth Observer 20 YEARS OF EVIDENCE INTO PRACTICE: REFLECTIONS ON THE OBSERVATORY 4 IN 10 (KEY) LESSONS – Suszy Lessof, Josep Figueras, Martin McKee, Elias Mossialos and Reinhard Busse HAPPY 20TH ANNIVERSARY @OBSHEALTH! WISHES AND TWEETS FROM COLLEAGUES 8 AND FRIENDS SELECTED HIGHLIGHTS FROM THE FIRST 20 YEARS – A BRIEF HISTORICAL 10 OVERVIEW OF ACTIVITIES AND PUBLICATIONS Eurohealth International THE ROLE OF THE HEALTH SYSTEM IN THE 21ST CENTURY: THE ROAD FROM 12 LJUBLJANA TO TALLINN – Martin McKee, Suszy Lessof and Josep Figueras EVOLUTION OF HEALTH SYSTEM PERFORMANCE ASSESSMENT: THE ROLES 15 OF INTERNATIONAL COMPARISONS AND INTERNATIONAL INSTITUTIONS – Peter C. Smith, Marina Karanikolos and Jonathan Cylus EU INTEGRATION AND HEALTH POLICY AT THE CROSS-ROADS – Willy Palm 19 and Matthias Wismar CONTENTS Eurohealth Systems and Policies 20 YEARS OF HEALTH SYSTEM REFORMS IN EUROPE: 23 WHAT’S NEW? – Cristina Hernández-Quevedo, Anna Maresso, Sherry Merkur, Wilm Quentin, Erica Richardson, Anne Spranger and Ewout van Ginneken REFORM DIRECTIONS – CHANGING CONTEXTS AND ENDURING CHALLENGES – 28 Comments from Richard Saltman GETTING AND KEEPING PEOPLE HEALTHY: REFLECTING ON THE SUCCESSES AND 29 FAILURES OF PUBLIC HEALTH POLICY IN EUROPE – Gemma A Williams, Bernd Rechel, David McDaid, Matthias Wismar and Martin McKee UNIVERSAL HEALTH COVERAGE AND THE ROLE OF EVIDENCE-BASED APPROACHES 34 IN BENEFIT BASKET DECISIONS – Juliane Winkelmann, Dimitra Panteli, Miriam Blümel and Reinhard Busse DEVELOPMENTS IN EUROPE’S HEALTH WORKFORCE: ADDRESSING THE CONUNDRUMS – Matthias Wismar, Claudia B Maier, Anna Sagan and Irene A Glinos European 38 Quarterly of the European Observatory on Health Systems and Policies EUROHEALTHon Health Systems and Policies RESEARCH • DEBATE • POLICY • NEWS Observatory 20th Anniversary Special Issue Eurohealth Monitor 43 HSPM COUNTRY NEWS • 20 years of evidence into practice • What's new in health system › 2018 Observatory reforms • Happy Birthday Observatory | • Successes and failures of public MY FAVOURITE OBS BOOK OR ACTIVITY 20th Anniversary • The role of health systems in the health policy 21st century Special Issue • Universal coverage and evidence- Number 2 • Evolution of health system performance | based approaches assessment • Reframing the health workforce • EU integration and health policy at the cross-roads :: Special Issue :: Volume 24 Philipp Konrad / EyeEm 45 Eurohealth — Vol.24 | No.2 | 2018 2 Twenty years of evidence into practice This special issue of Eurohealth marks the 20th anniversary of the European Observatory on Health