The four FRESHER Scenarios 

Governments, the private sector and citizens’ networks collaborate closely to develop solutions to promote quality of life, healthy opportunities and efficient care.  When governments take the lead, citizen participation is ensured throughout the policy making process, to promote equity, sustainability and human health in all policies. There is high value to leisure, sense of community and nature. Fair incomes level up living conditions, ensuring better standards to all.  A new socio-economic pattern provides for the means to take better care of one’s own health but also to care about others through informal networks and community engagement Recycling and sharing practices lower the focus on productivity and the pressure on the environment.

Thanks to big data, public and private investments effectively influence citizens’ behaviour towards healthy lifestyles. Employers provide healthy working environments and care services provided. Fair labour legislation is implemented to give workers money, time and knowledge to take better care of their health. The top down approach is ensured by ambient 24/7 surveillance and implanted chips for affordable early diagnostics, tele-medicine and tailor-made treatment. The new era of economic growth and social progress focused on delivering more to everyone, with environmental sustainability seriously overlooked. Increasing economic and environmental migrants are let in following strict immigration policy and by considering only their skills and possible contributions to the EU economy’s growth.

Market forces are dominant and a ‘light government’ guarantees their functioning. European states have privatised the health-care sector to reduce the debt and have deregulated labour to revitalise the economy. Health is now just like many other services: potentially available but expensive. Human health and lifestyle are left to individuals’ choices and capacities. The more you can afford it, the better treatment you get, thanks to expensive medical innovations including new-generation biomedical devices. The global protection of the environment is ensured by pricing it. It is a socio-economic system where most of the economies are decarbonised and climate change is now under control. However, global governance focuses on achieving results, without considering level of inclusion of the solutions pursued. The demolition of welfare states has created new challenges: the growing tensions among citizens make security issues rise in the political agenda and the number of marginalized citizens increases.

To gain some legitimacy, national governments cooperate with different stakeholders for policies that are short-sighted and do not consider health implications. Economic stagnation has led many countries to gradually reduce number of people that can avail public services, increase user charges for services and limit the number of public health providers. “Health shocks”, defined as unpredictable illnesses that diminish health status, increase and innovative medicines, focusing on quick-fix solutions, and treatments remain hardly affordable for European states and citizens. The deterioration of living standards undermine the community values and lead to tensions among citizens and mistrust in policies. Citizens suffer the consequences of climate change as international agreements have stalled for decades.