Healthcare Policies and Systems in Europe and China. Comparisons and Synergies

While facing different stages of economic development, China and Europe share same demographic concerns and sustainability issues. Europe has developed good practices of universal healthcare systems, but significant and dramatic changes that have taken place over the past two decades have led to a decrease in health expenditure and a decline in public assistance. Several European countries need to improve public services, especially for the growing aging population, while concurrently decreasing healthcare spending. Europe has vast experience in developing and operating healthcare policies including prevention and long-term care assistance. European industries have reached a scale of efficiency, global competitiveness, and sophisticated approaches to innovation in the pharmaceutical, equipment, and para-pharmaceutical sectors. On the other hand, China has embraced large reforms in the healthcare system to upgrade the quality and coverage of assistance provided to the Chinese people. Within this process, the universal healthcare system has been chosen as the benchmark. Multiple strategies have been promoted on both the supply and demand sides. Similar to Europe, China is experiencing the challenges associated with an increasing aging population. The geriatric population requires appropriate, specific, and long-term healthcare assistance, which costs significantly more than those services consumed by a comparatively younger population. A Europe–China partnership in the healthcare domain could be a win–win strategy for several reasons. Potentially, Europe and China have complementarities that could help each other face their specific needs in the long run. In this scenario, China would benefit from gaining knowledge and expertise from European countries at different levels: From how to project and run a universal system and how to plan a specific care program for its aging population to the use of Western medicine (WM) to cope with new and improved medical needs of the population. Europe could “export” to China solutions and best practices, and thus find business opportunities. At the same time, China could export to Europe practices and approaches of traditional Chinese medicine (TCM) that could be cost-saving and effective in specific pathologies. A multidisciplinary team has contributed to this book, following the research activity and international mobility program carried out in the 4 years of the “People Marie Curie Actions Fp7-People-2013-Irses” CHETCH, i.e., China-Europe taking care of Healthcare solutions (GA n. 612589). Researchers in the social science and humanities area have compared the European and Chinese healthcare systems at different levels, including value systems and ethical issues. The economic experts have analyzed the integration reached between China and Europe in the healthcare-related industries (technologies, pharmaceutical, and other). Foreign direct investments and trade flow trends were studied at the regional and provincial levels. The typical cost–benefit tools were used to evaluate the economic impact of integrating WM and TCM practices, supporting the medical team of experts. The legal instruments have defined obstacles and plausible solutions that can be generated by the regulatory environment, as well as appropriate solutions to enhance collaboration both at institutional, medical practice, and business levels. The team of experts in the medical field have investigated several areas of integration. The team has developed a process of recognition and scientific validation of TCM versus complementary alternative medicine (CAM) at different levels, as recommended by the World Health Organization Traditional Medicine Strategy 2003-2005. A central role was played, in the whole project, by acupuncture. Indeed, in the social and historical context of Europe, the integration of acupuncture in European Healthcare Systems is an opportunity. The main motivation is the increase in the elderly population and in chronic diseases: the chronic patient is a frail patient with poor quality of life who generates costs to the healthcare system, with direct and indirect costs. The elderly patient often takes polypharmacological therapy, which reduces therapeutic compliance and causes side effects. Evidence-based medicine (EBM) demonstrates that acupuncture is effective in treating chronic diseases, particularly pain, improves the quality of life, and helps to reduce/eliminate drug intake, significantly reducing the problem of side effects. Other fields of application of acupuncture, alone or integrated with WM, are as a support to fertility and assisted reproduction therapy (ART) and for the treatment of side effects caused by oncological therapies. Acupuncture has proven to be safe and costeffective, and the EBM data are favorable to its integration in the National Healthcare System. Nevertheless, to practice acupuncture, appropriate training is fundamental. The gold standard role is played by the physician (medical doctor), who has to combine western medicine training with an appropriate amount of hours of theoretical and practical learning of acupuncture and Chinese medicine. Other professionals, apart from the medical one, must have theoretical and practical training, at least equal to that offered in China to Chinese medicine students in Chinese traditional medicine universities, to achieve a sufficient expertise in patient management. Thanks to its multi-level analysis, the book contributes to increase the availability of interdisciplinary studies providing a comprehensive overview (including medical, legal, economic, and humanities perspectives) of Europe–China relations in the healthcare domain. This comprehensive study is also the base for further projects where the integration of WM and TCM needs to be further explored and developed, also on the basis of scientific evidence of the strong benefit that both patients and systems can get. Nevertheless, a cultural shift is needed to change the perception, in Europe, about the role and foundations of TCM. Training programs and specific public engagement activities are needed to increase the awareness of the tremendous achievements that Europe could get by deeply integrating TCM with the Western approach for the benefit of the patient and their treatments.