21 th September 2010

1. Healthcare in Europe and in the USA Presentation of the results 21th September 2010

2. Technical pieces of information Studied countries and historical background: • 2006 - 2007 : • 2009-2010 : • 2010 : Germany France Italy UK Sweden Germany France Italy Sweden Poland UK Germany France Italy Sweden Poland USA UK Austria • Technical pieces of information: • Telephone interviews • Respondents profile: general public, aged18+ • Sample size: 3600 interviews : 400 per country and 800 in the USA. • Representativeness (per country) ensured by quotas set on age, gender, SEC class and region.

3. Introduction Studied topics: • Assessment of the healthcare system and of quality of care • Focus on doctors competence and training • Healthcare and social requirements • Patients mobility for access to treatment • New technologies • Prevention • Management of ageing and dependent people • Comparison across countries

4. 1 –Assessment of the healthcare system and of quality of care

5. 1 – Healthcare system How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? Excellent Very good Good Average Poor DK

6. 1 – Healthcare system – synthesis using the scores How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? Score « organisation of the health system » Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1

7. 1 – Healthcare system – synthesis using the scores How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? And is the quality of health care provided when consulting a general practitioner ? And, in your opinion, is the quality of care provided during hospital stays…? Score « organisation of the health system » Score « quality of health care provided by a GP » Score « quality of care provided during hospital stay » Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1

8. 1 – Healthcare system Evolution since 2006 of the opinions on the health system’s organisation Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 09 10

9. 1 – Healthcare system Evolution since 2006 of the opinions on the quality of health care provided by a GP Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 09 10

10. 1 – Healthcare system Evolution since 2006 of the opinions on the quality of care provided during hospital stay Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 09 10

11. 1 – Healthcare system Threats on the health system In the coming years, our health system will have to face several threats, which I am going to read to you. For each of them, do you feel that the threat is very important, somewhat important, not really important or not at all important?

12. 1 – Healthcare system Threats on the health system In the coming years, our health system will have to face several threats, which I am going to read to you. For each of them, do you feel that the threat is very important, somewhat important, not really important or not at all important?

13. 1 – Healthcare system Constant improvements in the quality of treatments are leading to additional spending. To pay for these additional costs, what do you think is the best solution? • Increase private insurance, optional supplemental insurance or supplemental policies from mutual insurance companies • Increase taxes or compulsory contributions • Pay a greater excess for each medical service DK

14. 2 – Focus on training / communication: perception of doctors training and competence

15. 2 – Focus on training/ communication – synthesis on doctors competence Let's talk about the competency of doctors in [FR/UK/GE/IT/PO/SU/US] At the moment how do you rate their technical skills (for diagnosis and treatments)? At the moment, how do you rate their interpersonal skills (to inform and explain)? How do you rate the sharing of information and the coordination of care between the hospital doctors and general practitioners? Score technical skills (for diagnosis and treatments) Score interpersonal skills Score sharing of information and the coordination of care Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1

16. 2 – Focus on training/ communication – synthesis on doctors training How do you rate the training that doctors receive during their medical studies? How do you rate the ongoing knowledge acquisition that doctors receive throughout their careers? Score training during medical studies Score ongoing knowledge acquisition Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1

17. 3 – Social requirements

18. 3 – Social requirements Does the current health system guarantee equal access to medical care for all citizens of FR/UK/GE/IT/PO/SU/US? Yes No DK

19. 3 – Social requirements To guarantee all citizens equal access to quality care, are you for or against an increase in contributions/taxes? Against DK For

20. Current affairs – 2010 update Have the consequences of the economic crisis caused you to cancel or postpone health care actions such as visits to the doctor, tests, surgical procedures, dental care or prescription drug purchases? • Yes, I have already done so • Yes, I may be forced to do so No, itwill not change anything DK

21. Current affairs – 2010 update Have the consequences of the economic crisis caused you to cancel or postpone health care actions such as visits to the doctor, tests, surgical procedures, dental care or prescription drug purchases? 09 10 09 10 09 10 09 10 09 10 09 10 + 12 points + 12 points • Yes, I have already done so + 5 points + 5 points - 2 points

22. 4 - Mobility

23. 4 – Mobility Imagine that you need surgery. Would you prefer to go to...? …A specialised surgeon from a distant city • …A generalist surgeon close to where you live DK

24. 4 – Mobility Would you be willing to travel abroad to gain access to a medical technique that you feel to be of identical quality but at a lower price than in [FR/UK/GE/IT/PO/SU/US]? Yes No DK

25. 4 – Mobility Imagine that you are choosing a holiday destination abroad. How much importance do you give to local health conditions when you are choosing your holiday destination? Little importance No importance at all DK Considerable importance

26. 4 – Mobility Now imagine that you had to go and live in another country. How much importance do you give to the proximity of doctors and hospitals to your new place of residence? Little importance No importance at all DK Considerable importance

27. 5 – New technologies

28. 5 – New technologies Do you use the Internet for information relating to healthcare? DK Yes, regularly Yes, occasionally No, never

29. 5 – New technologies Do you use the Internet for information relating to healthcare? Yes, regularly Yes, occasionally 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 06 07 09 10 09 10 +15 points +21 points +14 points +2 points +14 points +10 points

30. 5 – New technologies Do you dare to talk with your doctor about health information that pertains to you that you saw on the Internet? (To thosewho use the Internet for information relating to healthcare ) DK Yes No

31. 5 – New technologies What do you expect from a doctor with regard to health information available on the Internet? That he explain to me the aspects I did not clearly understand That he provide additional information beyond what I found That he tell me about reliable websites

32. 5 – New technologies Are you in favour or not in favour of the development of on-line medical consultations? Not in favour DK In favour

33. 5 – New technologies Are you in favour or not in favour of the development of continuous in-home monitoring resources over the telephone or Internet (e.g. measurement of blood pressure and heart rate)? Not in favour DK In favour

34. 5 – New technologies Doyou think that these in-home medical surveillance or monitoring resources over the telephone or Internet…? Enable more patients to be independent in their homes Will dehumanise medicine

35. 5 – New technologies - synthesis Are you in favour or not in favour of websites where doctors can be assessed? Are you in favour or not in favour of websites where hospitals can be assessed ? In favour of websites where hospitals can be assessed ( les 18- 39 y.o. most in favour ) In favour of websites where doctors can be assessed?(18- 39 y.o. most in favour)

36. 6 – Prevention

37. Current affairs – 2010 update To prevent risks stemming from the appearance of new epidemics like bird flu, mad cow or the A/H1N1 flu, do you want the State to spend...? More No change Less DK

38. 6 – Prevention Have had a check-up at the dentist during the last year Have been for a check-up over the last five years Have been tested for a serious disease like cancer or AIDS overs the last five years Are interested in a lifelong health monitoring programme

39. 6 – Prevention -synthesis It is now possible to purchase a lifelong health monitoring programme which includes preventive consultations and an annual personalised check-up. Are you personally interested in this monitoring programme? Who would pay? (Aux intéressés) / How? Interested in and payment Via the employer Via taxes Direct payment via the insurance Not interested DK

40. 6 – Prevention In the context of your job, do you feel that you need health programmes for...?

41. 7 – the 5th risk: management of ageing and dependent persons

42. 7– Ageing In your opinion, the care given to dependent elderly people is... Excellent Very good Good Average Poor DK

43. 7– Ageing Given the problems raised by increasing life spans and the rise in the number of dependent elderly people, which of the following should be our priority today? Home care Retirement homes DK

44. 7– Ageing Currently in our country, the public assistance provided to help dependent or elderly people stay in their homes is... • Absolutely satisfactory • Somewhat satisfactory • Somewhat unsatisfactory • Absolutely unsatisfactory DK

45. 7– Ageing Outside of their families, which organisation provides dependent elderly people with the best support to help them stay in their homes? Non-profit organisations Privateentities Public entities None DK

46. 7– Ageing To help dependent elderly people stay in their homes, do you think we must develop...? Home care jobs Remote monitoring which makes living at home safer Robotics which make it possible to perform daily tasks

47. 7– Ageing Two solutions are possible to finance services and daily care for elderly and dependent people : public funding stemming from taxes and compulsory public contributions, or cost totally met by the individual or the family either from a personal insurance policy or direct payment. Which of the following financing options would you most support?   • Total coverage by taxes and compulsory public contributions • Cost totally met by the individual or the family • Mix of state funding and personal/ family contributions DK

48. 7– Ageing Are you for or against compulsory private insurance to cover the costs of daily living for dependent elderly people? Are you for or against compulsory public insurance to cover the costs of day to day living for dependent elderly people? For a compulsory public insurance For a compulsoryprivateinsurance

49. 8 – Comparisonacross countries

50. 8 – Comparisaon across countries Of these seven countries, where does one receive the best care? Germany UK USA France Italy Poland Sweden 50% / 19% 4% / 0% 28% / 3% 38% / 11% 67% / 4% 31% / 1% 46% / 6% XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees