Three years after the beginning of the Covid-19 pandemic, mortality rates in Europe are approximately 10% higher than expected in a normal year. In mid-December 2022, the number of deaths in France and Germany were 25% higher. Squeezed budgets, sicker populations post-COVID, exhausted health and care workers and increasingly ageing European populations do explain, to some extent, these worrying trends. However, the question remains how to learn from the health pandemic and how to improve the efficiency and effectiveness of European health and care systems.