How can Europe afford to grow larger and older?

Date: 14/04/05

Two MEPs spell out their vision for welfare reform in the enlarged EU's ageing society

Europe must help new member states to raise their social standards and do away with destructively low tax rates, says Jean Louis Cottigny

Is a harmonised system of social protection in Europe really a dream for some and a nightmare for others? At a time when the constitution is being put to a popular vote in country after country, this question is always at the heart of the debate.

In terms of social protection, Europe is very much a collection of national measures onto which have been attached a few European directives, particularly for the protection of workers. Up to now, the European project has tended to focus primarily on economic or monetary issues, although the Treaty of Amsterdam in 1997 did go some way to redressing this imbalance. Our common goal is that Europe should work to serve its citizens. It should protect them, at the same time as allowing them to flourish as individuals. As such, the sort of social protection currently in place in many of the countries of Western Europe should not be undermined. To do so would be a grave political mistake.

It should be unthinkable to use the pretext of enlargement to undermine the rights of workers. To do so would create a dangerous situation in which the citizens of Europe were nothing but competitors, lined up against each other in the name of the free market. Jean Jaurès said that in order to achieve an ideal, it was first necessary to understand reality. As Socialists, even if our ideal remains an upward harmonisation of a social Europe, the reality is that of the market society. Yet, the two situations are not incompatible and should not stand in opposition to each other, at the risk of engendering a 'crisis'.

There can be no doubt that it is the uncertainty over the future of the European social model that is the cause of the 'No' to the constitution that we are now seeing in the opinion polls in France. There are certainly worrying developments that might give support to detractors of the European social model.

Today, globalisation is upon us and Europe must face up to the challenge. In the face of this globalisation, we have two possible choices.

One option would be to move towards all-out competition inside the EU at the same time as turning our backs on the outside world, allowing fiscal dumping and a social "race-to-the-bottom" amongst member states. This would result in a sort of laisser- faire attitude towards China and India. The consequences of such an attitude are well-known: jobs in industry would be exported more and more to the East. Job creation would become a predominantly Asian phenomenon. To compete effectively, the member states would be forced to reduce benefits and do away with social protection.

Another option, that which I subscribe to, would be that of solidarity and economic growth. Europe must help the new member states, in exchange for a progressive upward harmonisation of their social standards and an end to destructive fiscal policies.

In choosing this dynamic path, we would be being faithful to the ongoing ideals of the founding fathers.

It is this strategy - more growth for more solidarity - that Europe should adopt, with even greater vigour than the individual countries themselves.

Clemenceau said that war was too serious a matter to be entrusted to soldiers. I believe that Europe is too serious a matter to be left to those who have responsibility for it. Europe today is the product of three generations: those who witnessed the horrors of the war and who are rightly proud of their peace-making creation; those who, like me, see in Europe the reconciliation of East and West; and the young, who feel as though they are by nature citizens of Europe. Yet all these generations have one thing in common - what they expect from Europe is more generosity, more solidarity, and more humanity.

It is because I was born with Europe and because I hold Europe so dear to my heart, that I am convinced that it can be a place of progress and solidarity. And I am confident that what Europeans want is a social Europe.

• French socialist MEP Jean Louis Cottigny is a member of the employment and social affairs committee.

Politicians should not delay cost control reforms to cope with an ageing population just because they are unpopular, argues Zuzana Roithová

Europe is getting old. In the last 100 years, life expectancy has grown from 55 to 80 years. At the same time fewer children are being born so that in 2030 the population of the old continent will start to die out.

Longer life expectancy reflects both a higher standard of living, which has led to great reductions in infectious deseases, and developments in medicine. Most diseases are not terminal as they once were.

In some countries the population decrease can be slowed by immigration or by higher birth-rates among immigrant groups. But taken as a whole, an ageing population together with increased expectations of health services will bring to Europe social and cultural changes, great changes in health and social services system as well as, for example, in town planning and public transport.

The EU is becoming a retirement home. The number of seniors is increasing and the proportion of working people - those who are creating financial resources for the more and more expensive healthcare - is decreasing. In the Czech Republic, retirement-aged people consume 80% of health costs. This is the result of medical success rather than failure. Although the genetical predetermination of maximal life expectancy is 100 to 110 years because ageing has its biological limits, I am convinced that this trend is only approaching its peak. Politicians should not postpone the necessary cost control reforms even though they are not popular.

The medical possibilities and citizens' desire for quality health and social services are rising faster than the financial facilities of a European society based on a solidarity principle. Public funds are created by those who are now healthy and rich, they contribute to the ill and poor.

The degree of intergenerational solidarity is more distinct in the post-communist countries than in the EU-15 and that is why the financial contrast is more obvious and getting into crisis there. It is displayed as hospital indebtedness, reduced investment in modernisation, lower salaries for medical workers and long waiting lists.

The need for reform is strongest in the new member states. A high degree of solidarity is part of our Christian values on which we have built our common European house. But boundless solidarity leads to abuse and to common poverty.

Experiences from socialist times in the new member countries vouch that this is not just a theory but fact. In those times the state was more responsible for health than people themselves. Services were for free and patients could not influence the price of services or the quality. Patients did not even know the price and used to visit doctors even with banal problems. This attitude survives even today when the treatment is financed from the public insurance. But attempts at reform are problematic because they are unpopular.

To be effective they have to make the patient more complicit in deciding on treatment or prevention. Patients must be involved in the system as consumers of services, knowing their rights and duties, able to take part in controlling quality and costs. But they must have enough comprehensible information. However it takes time and requires a political vision to change the patients'/voters' ways of thinking. The new member states are closer to this vision because they are under greater economic pressure. Their experiences - the good and the bad ones - are a benefit for the rest of Europe.

In addition to cost control, the objective of outside health care quality control is the most important element of medical reforms. More and more hospitals are subjecting themselves to voluntary national or international accreditation. Increasing patient mobility brings the necessity of raising confidence among patients and insurance companies in the quality and safety of services, disregarding state borders.

Although national systems are different, the basic principles are similar and possible solutions are similar: cost control, greater concern for the quality of health and social care. The recent EU enlargement is an opportunity to solve it together and to multiply forces for reforming health and social care.

• Czech centre-right MEP Zuzana Roithová is vice-chair of the Parliament's internal market and consumer protection committee and a former minister of health.

Two MEPs spell out their vision for welfare reform in the enlarged EU's ageing society.

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