Performance of long-term care systems in Europe. ENEPRI Policy Brief No. 13, December 2012

The evaluation of long-term care (LTC) systems carried out in Work Package 7 of the ANCIEN project shows which performance criteria are important and – based on the available information – how European countries score on those criteria. This paper summarises the results and discusses the policy implications. An overall evaluation was carried out for four representative countries: Germany, the Netherlands, Spain and Poland. Of the four countries, the Dutch system has the highest scores on quality of life of LTC users, quality of care and equity of the LTC system, and it performs the secondbest after Poland in terms of the total burden of care (consisting of the financial burden and the burden of informal caregiving). The German system has somewhat lower scores than the Dutch on all four dimensions. The Polish system excels in having a low total burden of care, but it scores the lowest on quality of care and equity. The Spanish system has few extreme scores. Some important lessons are the following. The performance of a LTC system is a complex concept where many dimensions have to be included. Specifically, the impact of informal caregiving on the caregivers and on society should not be forgotten. The role of the state in funding and organising LTC versus individual responsibilities is one of the most important differences among countries. Choices concerning private funding and the role of informal care have a large effect not only on the public expenditures but also on the fairness of the system. International research into the relative preferences for the different performance criteria could produce a sound basis for the weights used in the overall evaluation.

Performance of Long-Term Care Systems in Europe. ENEPRI Research Report No. 117, 21 December 2012

This report evaluates the performance of long-term care (LTC) systems in Europe, with a special emphasis on four countries that were selected in Work Package 1 of the ANCIEN project as representative of different LTC systems: Germany, the Netherlands, Spain and Poland. Based on a performance framework, we use the following four core criteria for the evaluation: the quality of life of LTC users, the quality of care, equity of LTC systems and the total burden of LTC (consisting of the financial burden and the burden of informal caregiving). The quality of life is analysed by studying the experience of LTC users in 13 European countries, using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Older persons with limitations living at home have the highest probability of receiving help (formal or informal) in Germany and the lowest in Poland. Given that help is available, the sufficiency of the help is best ensured in Switzerland, Italy and the Netherlands. The indirectly observed properties of the LTC system are most favourable in France. An older person who considers all three aspects important might be best off living in Belgium or Switzerland. The horizontal and vertical equity of LTC systems are analysed for the four representative countries. The Dutch system scores highest on overall equity, followed by the German system. The Spanish and Polish systems are both less equitable than the Dutch and German systems. To show how ageing may affect the financial burden of LTC, projections until 2060 are given for LTC expenditures for the four representative countries. Under the base scenario, for all four countries the proportions of GDP spent on public and private LTC are projected to more than double between 2010 and 2060, and even treble in some cases. The projections also highlight the large differences in LTC expenditures between the four countries. The Netherlands spends by far the most on LTC. Furthermore, the report presents information for a number of European countries on quality of care, the burden of informal caregiving and other aspects of performance. The LTC systems for the four representative countries are evaluated using the four core criteria. The Dutch system has the highest scores on all four dimensions except the total burden of care, where it has the second-best score after Poland. The German system has somewhat lower scores than the Dutch on all four dimensions. The relatively large role for informal care lowers the equity of the German system. The Polish system excels in having a low total burden of care, but it scores lowest on quality of care and equity. The Spanish system has few extreme scores. Policy implications are discussed in the last chapter of this report and in the Policy Brief based on this report.

The Criminalisation of Migration in Europe: A State-of-the-Art of the Academic Literature and Research. CEPS Liberty and Security in Europe No. 61, October 2013

In the last 30 years, a clear trend has come to define modern immigration law and policy. A set of seemingly disparate developments concerning the constant reinforcement of border controls, tightening of conditions of entry, expanding capacities for detention and deportation and the proliferation of criminal sanctions for migration offences, accompanied by an anxiety on the part of the press, public and political establishment regarding migrant criminality can now be seen to form a definitive shift in the European Union towards the so-called ‘criminalisation of migration’. This paper aims to provide an overview of the ‘state-of-the-art’ in the academic literature and EU research on criminalisation of migration in Europe. It analyses three key manifestations of the so-called ‘crimmigration’ trend: discursive criminalisation; the use of criminal law for migration management; and immigrant detention, focusing both on developments in domestic legislation of EU member states but also the increasing conflation of mobility, crime and security which has accompanied EU integration. By identifying the trends, synergies and gaps in the scholarly approaches dealing with the criminalisation of migration, the paper seeks to provide a framework for on-going research under Work Package 8 of the FIDUCIA project.

An agenda for the European Council: feasible steps to bring the eurozone back from the precipice. CEPS Policy Brief No. 274, 20 June 2012

In the run-up to the emergency European Council meeting at the end of June, Stefano Micossi outlines in this Policy Brief the main elements of a realistic and yet incisive policy package, capable of reassuring financial markets and a bewildered public opinion. It is more than Germany has been willing to accept so far but much less than many of the demands it will confront at the Council meeting. More importantly, it only requires a minimum of additional disbursements by the member states, while strengthening risk-sharing for sovereign and banking risks.

Trends and gaps in the academic literature on EU labour migration policies. CEPS Paper in Liberty and Security No. 50/December 2012

This paper provides an overview of the ‘state of the art’ in the academic literature on EU labour migration policies. It forms part of the research agenda of Work Package 18 of the NEUJOBS project, which aims at reviewing legislation and practices regarding the labour market inclusion and protection of rights of different categories of foreign workers in European labour markets. Accordingly, particular attention is paid to the works of scholars who evaluate the status of rights of third-country national workers in relation to labour market access, employment security, social integration, etc., in European legislation on labour immigration. More specifically, the review has selected those scholarly works that focus specifically on analysing the manner in which policy-makers have addressed the granting of rights to non-EU migrant workers, and the manner in which policy agendas – through the relevant political and institutional dynamics – have found their translation in the legislation adopted. This paper consists of two core parts. In the first section, it reviews the works of scholars who have touched on these research questions with respect to the internal dimensions of EU labour migration policies. The second section does the same for the external dimensions of these policies. Both sections start off by analysing the main trends in the literature that reviews these questions for the internal and external dimensions of European migration policies as a whole, and then move on to how these ‘trends’ can (or cannot) be found translated in scholarly writings on labour migration policies more specifically. In the final section, the paper concludes by summarising the main trends and gaps in the literature reviewed, and indicates avenues for further research.

Carbon Leakage: Options for the EU. CEPS Special Report, March 2014

This CEPS Special Report builds on the first deliverable of the project entitled “Carbon leakage: Options for the EU”. It identifies carbon costs, and the ability to pass through carbon costs, as the main risk factors that could lead from asymmetrical carbon policies to carbon leakage. It also outlines and evaluates, based on criteria discussed in the paper, options for detecting and mitigating the risk of carbon leakage in three jurisdictions, with special attention to the EU ETS (Emissions Trading Scheme). Based on the analysis of approaches currently used in a number of existing carbon pricing systems, it identifies the balance between the number of sectors identified as being at risk, and the amount of compensation provided as a risk mitigation measure, as the critical element in providing an optimum approach to address carbon leakage risks. It also identifies a risk-based approach to identifying sectors at risk as allowing for a better reflection of reality in a counterfactual argument. Finally, the paper concludes that while, with some exceptions, there has been limited carbon leakage until now, the past may not be a good reflection of the future and that measures need to be put in place for the post-2020 period. While examining a number of approaches, it identifies free allocation as the most likely way forward for mitigating the risk of carbon leakage. While other approaches may provide interesting options, they also present challenges for implementation, from a market functioning, to international trade and relations, points of view. A number of challenges will need to be addressed in the post-2020 period, with many of them part of the EU ETS structural reform package. Some of these challenges include, among others, the need to recognise, and provide for individual sectoral characteristics, as well as for changes in production patterns, due to economic cycles, and other factors. Finally, the paper emphasises the need for an open dialogue regarding the post-2020 provisions for carbon leakage as no overall Energy and Climate Package is likely to be agreed on until this matter is addressed.

Towards better health outcomes - What role for pharmaceutical innovation? EPC Policy Brief, 10 December 2015

From the current refugee crisis to ageing populations, and from rising healthcare prices to patients’ rising expectations: demands on European health systems continue to increase. Delivering health efficiently and ensuring the long-term sustainability of healthcare in the face of reduced public budgets requires new thinking – and there is a role for pharmaceuticals as well. Building on the series of discussions organised under Transformations, this Policy Brief focuses on the specific role of medicines and pharmaceutical innovation in improving health outcomes. It considers the state of play of drug innovation, from the development to the deployment of medicines, and the measures needed to make it deliver more for society and the economy, while ensuring that patients in Europe can have access to innovative and safe solutions.