Analyst Insight by Ewa Hudson.
It's not the economy – healthcare will be the new topic to exercise the growing class of the “forever young”. It's a well-known fact that everyone wants to live to a ripe old age, but no-one wants to be old. Certainly no-one wants to be sick.
While health is becoming a status symbol for the new old, the number of young people who are interested in preventing illness is growing. Yoga classes, gyms and swimming pools are favoured meeting places, and everyone seems to be running marathons now.
- Goodbye to traditional national healthcare systems?
- Health tourism;
- Obsession and hypochondria;
- Proactive alternatives.
- Health topics are now regular features across all types of media. Phenomena like the high circulation German “Apotheken Umschau” free giveaway magazine indicate that health is a topic at the forefront of people's minds;
- While an ageing society across Europe will pose a challenge to industries such as fashion and consumer electronics in the medium to long term, there will be significant growth in all areas touching on health and wellness;
- An article in a recent issue of the McKinsey Quarterly magazine sees the industry shifting from a wholesale to a retail model, with a new market of consumers demanding clearer information and personalised support. It recommends that companies pay attention to their needs, desires and habits in order to stay ahead in the dynamic health market;
- The growing concern about health issues is also opening up pan-European opportunities for “health tourism” with consumers seeking cheaper dental, optical and orthopaedic treatment in the less affluent European countries. The already flourishing sector of spa tourism will remain another growth industry.
Goodbye to traditional national healthcare systems?
Many national health systems in Europe are now creaking under the weight of their aging populations. Since the War, people have become used to being given free medication through their health insurance. Now, major healthcare reforms are in the pipeline in France and Germany.
The introduction of reference pricing in Spain as well as the Pharmaceutical Price Regulation Scheme in the UK are slowing down pharmaceutical expenditure. Graham Lewis, IMS Vice President Europe (Pharma Strategy) describes the challenge for the pharmaceuticals industry: “As new drugs are developed to meet the needs of an aging population, most of whom are pensioners, new products must combine efficacy with affordability.”
This concern is shared by consumers, as a recent survey by the McKinsey consulting company finds that “among consumer concerns, the cost of health care is paramount”.
The number of pharmacies is decreasing across Europe as consumers buy more OTC or “alternative” self-medication in drugstores and food retailers. In Germany the number of pharmacies has remained stable since 1999, but in many other countries, such as Portugal, Italy, Spainand France, the ratio of pharmacies to inhabitants is higher.
The French, according to statistics published in the UK's Guardian newspaper, take three times as many prescription drugs as the Germans and the British, and twice as many as the Italians. A recent French survey estimated that doctors were prescribing mood-altering medicines to 12% of the adult population.
53% of German consumers complain that doctors in hospitals don't have enough time for their patients. The former total trust in doctors and the health system that the pre- and post-war generations still enjoyed (respectfully called Herr Doktor or Onkel Doktor by German children) has given way to a more critical view of the limits of the traditional medical system.
- Increasing numbers of consumers use the internet for a diagnosis of what they think ails them. There are self-help health internet forums for just about everything now, from lupus to MS, from cancer to Alzheimer's, from strokes to athlete's foot;
- In the UK, the recent boom in self-help literature has fed a rise in the number of people borrowing self-help books from libraries, and TV diet expert Gillian McKeith at the top of the most read non-fiction titles. Her bestselling book, “You Are What You Eat”, is at number one, with hypnotist Paul McKenna in fourth and fifth place;
- This year, the Swedish Government released a patient-centred national e-health strategy designed to ensure that health information is available when it is needed for providing patients with access to personal information on their own care, treatment and health status.
When the limits of what discount pharmacies and self-medication can offer are reached, and more cost-intensive treatments are needed, the number of Europeans from wealthier countries seeking treatment in the newer member states is growing. New style travel operators such as German Go East Reisen GmbH specialising in arranging dental travel to Hungarian border towns have established themselves as centres for this kind of treatment.
There are medical centres in Istanbul, Poland and the Czech Republic offering cheap laser eye treatment under the umbrella of “Lasik tourism”. Some of these treatments are now paid for by the German mandatory health insurance schemes. They also allow for the “Kur”, or “la cura”, the preventative spa treatment, to be taken abroad, where quite often it works out cheaper. The “cure” used to be a staple of central European and Italian health care.
Payments have been cut to a minimum by the health services, but the more affluent health seekers have revived it privately, leading to a boom in spa and wellness holidays, from walking tours in the Italian South Tyrol and taking the waters in legendary Czech Karlsbad and Marienbad, to Yoga breaks in Mallorca and holistic Ayurveda applications in Sri Lanka.
The latest mass phenomenon in health tourism is the trip to cheap cosmetic surgery – Europeans travel to Tunisia and to Korea, to Thailand and Colombia, to have their bellies liposuctioned and their noses refined. A website: www.europeanmedicaltourist.com even advises on treatments such as lap band surgery, gastric bypass and duodenal switch.
Obsession and hypochondria
If you believe the growing number of self-help books, health is all in the head. Be positive, eat well and exercise to stay well. Countless magazine articles across the spectrum remind readers of the importance of the “five a day” campaign (of eating five helpings of fruit and vegetables).
Consumers are advised to eat fibre, the “superfoods” and the foodstuffs of countries where people seemingly live forever: garlic in Georgia, yoghurt in Mongolia, olive oil in Greece and raw fish in Japan. Smoking has turned whole strata of citizens into lepers thanks to smoking bans in many European countries – accepted and even welcomed by many, resisted by the few.
In Eastern Europe, some wellness-led Western lifestyle changes are less popular. In the “eurotopics” internet magazine, researcher Nina Diezemann finds that in Romania, the press mocked the smoking ban as “a classic case of banning everything that's beautiful”, while Bulgarians feel it deprives them of their identity, since “Schnapps, salad and cigarettes are half a Bulgarian's life, and without them life is boring and sterile as a cucumber”.
As new and mysterious illnesses are appearing, old ones are cherished. Most girls think they are fat and so anorexia nervosa and bulimia have been exercising parents throughout the more affluent parts of Europe. While in England many people are afflicted with ME or mysterious new syndromes such as Tension Myositis Syndrome (TMS), in Germany these conditions remain largely unknown. Instead, Germans claim endless complications with slipped discs or with their circulation.
The French suffer the perennial “crisis de foie” (liver crisis) which can be cured by a number of medicines (some say placebos) every French pharmacy sells over the counter. Is it just a coincidence that a French writer, Moliére, gave us the “Malade Imaginaire”, the original hypochondriac? Meanwhile, we envy the Spanish, the Greeks and the Italians – they eat well, drink lots of wine, get fresh air in the streets, squares and on the beaches, enjoy midday naps and seem to enjoy enviably good Mediterranean health.
Everyone agrees that aspirin is a panacea for just about everything and generally a good thing. But the warning voices are growing louder: don't take too many antibiotics, inform yourself about the side effects of various medications you are taking, do exercise instead of having that knee operation….With the growing disillusion in the omnipotence of Western medicine, the hunger for alternatives has grown.
The range of treatments now available and the booming practices of Chinese herbalists, Reiki and Feldenkrais, acupuncturists and osteopaths testify to this. In Germany, the “Heilpraktiker” and Kneipp water treatments have long been the folk alternative to conventional medicine. The UK was the first European country where homeopathy, osteopathy and acupuncture became a firm part of medical treatments on offer.
Although the medical establishment often pronounces dire warnings about inexperienced practitioners and questionable results, the popularity of alternative medicine is growing in relation to the disillusionment with conventional, assembly-line treatments.
While many believe in relaxation for good health, one of the more tried and tested ways to keep young and fit is sport, and this is becoming an invaluable lifeline for the older generation. The German IfD Allensbach market research institute finds that while in 1987 only 52% of 60-74 year olds claimed to go swimming regularly (20% over 75), by 2007 this share had gone up to 61% and 31% respectively. Statistics published in the UK's Daily Telegraph inform us that the average age of the marathon runner is now 41. UK runner Buster Martin is claiming the record at 101 years.
In the Eighties, everybody smoked and drank coffee and spirits. In the Nineties, the first coffee bars serving decaff, low-fat organic soya-milk cappuccinos appeared on the European scene sending shock-waves through coffee house culture.
The horror spectres of anorexia, bulimia and obesity gained media attention, and, with orthorexia (an obsession for eating 'healthy foods), a new problem was born. The green and LOHAS movement added to the growing feeling that personal health was as important as a healthy earth. Health may be about beauty when you are young, but as Europe is getting older it is about life itself.