Major health care reform in Austria

Austria, a country with a highly complex federalised and socialist health care system, is about to see radical change in healthcare under the new centre-right and far-right government. A powerful new health minister has close ties with the private sector.

Martin Brunninger, a partner at investment banking house and consultancy Goetz Partners said that the new government coalition, which won nearly 60% of the popular vote, plans to merge all the regional and corporate statutory insurers into a single payor: “It is the most radical change since world war two.” It also plans to beef up primary care which is patchy with citizens, particularly in cities, often going direct to specialist doctors. Meanwhile, the government has merged the social affairs and healthcare ministries into a single ministry under Beate Hartinger-Klein, 59, from the Freedom party.

Brunninger adds: “The programme foresees the introduction of accountable care organisations helped by digitalisation and a further push of the electronic patient record.”

Austrian academic and conslutant Maria Hofmarcher-Holzhacker at HealthSystemIntelligence is a little more sceptical:  “Even though the government is willing to do a lot, I am not sure how far they will get. Hartinger-Klein is also quite under pressure and her room of manoeuvre is conditional on what party leaders want to push for.” Here is her analysis of the programme with a summary in English on page 4.

So what impact will this have on the private sector? Today, for-profit operators are restricted to a developing nursing home and spa/rehab sector and a few private hospitals in Vienna which cater mainly for East Europeans. Many sectors are out of bounds. Dentists, for instance, can only own a practice if they work there.

The background of the new minister suggests that the government may become much more pro-private sector. Brunninger said: “She worked for Fresenius Vamed as a consultant as well as at Deloitte. She has also worked as a deputy CEO in one of the regional insurers. So she knows a thing or two about healthcare.  Really, she is a moderate technocrat when it comes to healthcare.” Hofmarcher-Holzhacker agrees that Hartinger-Klein is professional.

The big question is how statist the far right in Austria will prove to be? In Poland, France and Hungary such parties tend to favour the public sector in healthcare and are scared of free markets. However, Brunninger says that the plans involve putting the patient first and there is talk of more stakeholders. Hofmarcher-Holzhacker says the centre right partner is more private sector friendly than the Freedom Party.

The new government won nearly 60% of the vote. Given that share of the vote, it is likely to be in power for a decade.

We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.