unearths how politics is playing a part in the development health
care leasing in different countries.
To understand the strength of health care leasing in a
particular country then look no further than the politics that
surround them.
Go deeper with GlobalData
Government reform in Sweden has given rise to a shift away from
public sector health care leasing – although this move has been
offset by a growth in asset finance in the private sector.
Meanwhile, according to Jeremy Knight, UK country manager at GE
Health care Financial Services, leasing is the most favoured
alternative financing option for medical technology in France,
Germany and the UK, because of the stability of their governments
and public sectors. But medical equipment leasing also relies on
the strength of medical device markets and health care
manufacturers.
France
According to figures published by Deloitte, the French medical
device market is the fourth largest in Europe, with a value of €5.1
billion in 2007. France is also one of the OECD’s darlings in terms
of effective health care spending. Its health care leasing market
is one of the most mature in Europe.
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By GlobalDataHowever, France is experiencing a growing deficit in the
national health insurance scheme, and the medical device sector
will consequently see only moderate growth to an expected €6.6
billion by 2012. Nevertheless, the medical device financing sector
is expected to remain strong, particularly in imaging and
radiotherapy equipment financing.
Also, a culture of competitiveness and achievement is currently
being rewarded in the health care equipment financing sector.
France’s ‘Hôpital 2007’ reform will see hospitals’ funding being
progressively based on results and not on their spending.
According to HBS Consulting, this is likely to give rise to a
greater emphasis on the role of equipment leasing in the health
care sector
Germany
Similarly, the German medical device market, which is the
largest in Europe, is also experiencing a slowdown, according to
consultancy BVMed. Meanwhile some lessors say there has been a
slight decline in the medical device leasing market.
Since medical leasing is concentrated in the private sector,
there is a large mixture of bank financing, leasing and hire
purchase. Finance lease is the dominant product type as “customers
are concerned about owning the asset at the end of the lease
period”, Kim Egger, commercial director of health care Europe at De
Lage Landen, says. Transparency is important, and thus bundled
leasing has not had a large take-up, but vendor relationships have
remained strong.
Italy
The Italian medical device leasing market is also large, and its
system is similar to the UK with a matching NHS-type model.
Finance leases are the sole product, while vendor financing is
also possible, according to Egger: “All the finance and equipment
purchasing is tendered like the UK, but unlike the UK there is a
strong relationship between financiers and manufacturers. In most
tenders the financial proposal is requested to the manufacturer so
the tender request for equipment and financing is made in one.”
Central and Eastern Europe
Meanwhile, there has been a slow but steady uptake of medical
equipment leasing in the CEE, although many major European
financiers and vendors have found the CEE market fragmented and
challenging.
This is predominantly because higher risks are associated with
leasing such high-volume and expensive equipment in markets where
manufacturers are subject to less competition and regulation.
This is enhanced by the dominance of the public sector in CEE
countries' health care markets. Unlike in Western Europe,
leasing to these sectors is more risky than to the private sector,
according to a source at Philips Medical Captial. The source adds
that as 90 percent of leases are public sector “it prevents the
development of classical leasing because most contracts go to
tender”.
Romania
Romania, where leasing constitutes a significant proportion of
the equipment leasing market, is running increasingly short of
funding for the health care system.
According to Romanian Leasing Association director Adriana
Ahciarliu: “I do not see this field of activity will be much more
developed, because they [lessees/doctors] will not be able to
contract financing from private sources as they are dependent on
the state.”
Czech Republic
Similarly, Czech Leasing Association general secretary Jirí Pulz
says: “No lessor specialises in health care equipment leasing
because the majority of funding is from the state.”
He adds: “Although funding is drying up, it is being paid for by
public resources and respective donations, which means there is not
much space for leasing in the public sector. But the new right wing
government has more space for privitisation of health care in its
programme.”
