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From prevention to cure which policies for primary care ?

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Page 99

COMMUNICATION

From prevention to cure : which policies for primary care?

Catherine Gourbin* and Guillaume Wunsch**

Introduction

Though mortality has decreased dramatically in most of the industrialized countries, leading to life expectancies of over 80 years of age for females and slightly less for males, one cannot conclude that all public health problems are progressively being solved. Actually, as one knows, due to the increasing length of life and very low fertility levels, all populations in the developed coun¬ tries are growing older and older. As health often deteriorates with age, as medical technology is growing both in quality and quantity but also in cost, and as our expectations for guaranteeing a healthy life are rising, health costs are soaring in all the devel¬ oped world. Governments in Europe are trying to contain the costs by taking various measures, such as rationing of health-care interventions and reducing the coverage of the insurance funds to more basic services, increased co-payment or direct out-of-pocket payment by patients to providers, stimulating additional volun¬ tary contributions to private health insurance funds, favoring competition among insurance funds, and more generally trying to improve the health system's performance.

Among this set of more or less ad hoc policies, one of the goals of policy makers in the health field is to develop better preventive

University Center of General Practice and Institute of Demography, University of Louvain (UcL)

** Académie royale de Belgique and Institute of Demography, University of Louvain (UcL)

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