October 9-12, 2003

Schloss Hohentübingen, Tübingen, Germany

International Symposium funded by the Fritz Thyssen Foundation.
Internationales Zentrum für Wissenschaftliche Zusammenarbeit, University of Tübingen
Scientific Coordination:
Georg Marckmann, MD, MPH, Prof. Urban Wiesing, MD, PhD,
Institut für Ethik und Geschichte der Medizin, University of Tübingen
Contact: This email address is being protected from spambots. You need JavaScript enabled to view it.

Background and aims of the symposium
Scientific Program & Presentations

Background and aims of the symposium

All industrialised nations face steadily rising health-care costs. To limit health-care expenditures several countries like Norway, Sweden, the Netherlands or New Zealand have taken steps to set priorities in their health-care systems. While Germany tried to curb the health-care cost inflation mainly with global budgets, these nations decided to make explicit choices between the various preventive, diagnostic and therapeutic measures that modern medicine has to offer: What medical services are more important than others? What services should be covered in the publicly financed health-care system? In addition, these countries also want to find ways to make the most efficient use of scarce health-care resources. The biomedical progress, demographic changes and increasing public expectations will further increase the gap between demand for health care and available resources in the future.

At the same time, many countries of the former “Eastern Bloc” – the so-called transitional economies – face questions of priority in restructuring their health-care systems. While setting priorities in the western countries aims at limiting the range of services that are covered within a public system, the eastern nations have to set priorities in expanding the available health-care services within the given resource constraints. From two different sides, East and West approach the same goal: An efficient and hence affordable health-care system that provides access to a core of essential health-care services.

Clearly, deciding what health care services are basic or important involves not only scientific but also value judgements. As priorities in health care cannot be determined by reference to scientific or ethical theory alone, any model of priority setting must be informed by public or community values. Therefore, designing and implementing fair political procedures to elicit health-related values and preferences is the big challenge of priority setting in health care. The symposium shall provide the possibility to share the experiences from different countries. While the “western” nations already have engaged in a more intensive dialogue on priorities in health care (cf. the International Society on Priorities in Health Care), there hasn’t been much exchange between the East and the West so far. Both eastern and western countries, however, certainly could benefit from mutually sharing their experiences: Eastern countries could learn from the western experience with setting priorities in a comprehensive health care system (e.g. how difficult it is to reduce coverage) and western countries could get a better sense for what is really important in health care by sharing the eastern perspective of restructuring a health-care system from the scratch under conditions of resource scarcity. The main focus of the symposium is on the ethical basis of priority setting in health care: What (implicit and explicit) values guide the different approaches? How were the values elicited? How do the different countries balance conflicting values?

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Scientific Program & Presentations

Thursday, October 9, 2003
Introductory lecture:
Chris Ham (London): Priority setting in Health Care: what is happening around the world and why are values important?
Friday, October 10, 2003
Northern Europe:
Western Europe:
Saturday, October 11, 2003
Central and Eastern Europe: