Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T06:18:51.115Z Has data issue: false hasContentIssue false

The crisis as catalyst for reframing health care policies in the European Union

Published online by Cambridge University Press:  21 July 2014

Jan-Kees Helderman*
Affiliation:
Associate Professor at the Institute for Management Research, Department of Public Administration and Political Science, Nijmegen School of Management, Radboud University, Nijmegen, The Netherlands
*
*Correspondence to: Jan-Kees Helderman, Associate Professor, Department of Public Administration and Political Science, Institute for Management Research, Radboud University Nijmegen, PO Box 9108, 6500 HK Nijmegen, The Netherlands. Email: [email protected]

Abstract

Seen from the perspective of health, the global financial crisis (GFC) may be conceived of as an exogenous factor that has undermined the fiscal sustainability of European welfare states and consequently, their (expanding) health systems as well. Being one of the core programs of European welfare states, health care has always belonged to the sovereignty of European Member States. However, in past two decades, European welfare states have in fact become semi-sovereign states and the European Union (EU) no longer is an exogenous actor in European health policy making. Today, the EU not only puts limits to unsustainable growth levels in health care spending, it also acts as an health policy agenda setter. Since the outbreak of the GFC, it does so in an increasingly coercive and persuasive way, claiming authority over health system reforms alongside the responsibilities of its Member States.

Type
Overview
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Paper prepared for the special issue of Health Economics, Policy and Law on the impact of the macroeconomic crisis on health care.

References

Baumgartner, F. R. and Jones, B. D. (1993), Agendas and Instability in American Politics, Chicago: Chicago University Press.Google Scholar
Bevan, G., Helderman, J. K. and Wilsford, D. (2010), ‘Changing choices in health care: implications for equity, efficiency and cost’, Health Economics, Policy and Law, 5(3): 252267.Google Scholar
Council of the European Union (CEU) (2006), Joint Report on Social Protection and Social Inclusion, Doc. No. 7294/06, Brussels: Council of the European Union.Google Scholar
CEU (2007), Joint Report on Social Protection and Social Inclusion, Doc. No. 6694/07, Brussels: Council of the European Union.Google Scholar
European Commission (EC) (2006), Portfolio of overarching indicators and streamlined social inclusion, pensions, and health portfolios, http://ec.europe.eu/employment_social/social_inclusion/docs/2006/indicators_en.pdf [14 March 2014].Google Scholar
EC (2008), ‘Together for Health: A Strategic Approach for the EU 2008–2013’. White Paper, COM (2007) 630, EC, Brussels.Google Scholar
EC (2009), The 2009 Ageing Report: economic and budgetary projections for the EU-27 Member States (2008–2060) Joint Report prepared by the European Commission (DG ECFIN) and the Economic Policy Committee (AWG).Google Scholar
EC (2010a), Joint Report on Health Systems. Prepared by the European Commission and the Economic Policy Committee. Occasional Papers 74, December 2010. Brussels.Google Scholar
EC (2010b), Europe 2020: A Strategy for Smart, Sustainable and Inclusive Growth, Brussels: EC.Google Scholar
Esping-Andersen, G. (ed.) (2002), Why we need a new welfare state? Oxford: Oxford University Press.CrossRefGoogle Scholar
Fahy, N. (2012), ‘Briefing on current and future developments in European Union policy and practice in healthcareHealth Services Management Research (25): 152153.CrossRefGoogle ScholarPubMed
Ferrera, M. (2005), Boundaries of Welfare. European Integration and the New Spatial Politics of Social Protection, Oxford: Oxford University Press.CrossRefGoogle Scholar
Hay, C. (1996), ‘Narrating crisis: the discursive construction of the ‘Winter of Discontent’, Sociology, 30(2): 253277.CrossRefGoogle Scholar
Helderman, J. K. and Stiller, S. (2014), ‘The importance of order and complements. A new way to understand Dutch and German Health Insurance Reforms’, Journal of Health Politics, Policy and Law, 39(4): 811840.CrossRefGoogle ScholarPubMed
Hemerijck, A. C. (2012), Changing Welfare States, Oxford: Oxford University Press.Google Scholar
Hervey, T. K. (2008), ‘The European Union’s governance of healthcare and the welfare modernization agenda’, Regulation & Governance, 2: 103120.CrossRefGoogle Scholar
Keeler, J. T. S. (1993), ‘Opening the Window for Reform: Mandates, Crises, and Extraordinary Policy-Making’, Comparative Political Studies, 25(4): 433486.Google Scholar
Kingdon, J. W. (1984), Agendas, Alternatives and Public Policies, Boston: Little, Brown and Company.Google Scholar
Lindh, T. (2012), ‘Social investments in the ageing populations of Europe’, in N. Morel, B. Palier and J. Palme (eds), Toward a Social Investment Welfare State? Ideas, Policies and Challenges, Bristol: The Policy Press.Google Scholar
Majone, G. (1998), ‘Europe’s ‘Democratic Deficit’: the question of standards’, European Law Journal, 4(1): 528.Google Scholar
Mladovsky, P., Srivastava, D., Cyclus, J., Karanikolos, M., Evetovits, T., Tomson, S. and McKee, M. (2012), Health Policy Responses to the Financial Crisis in Europe, Policy Summary 5 Copenhagen: World Health Organization/European Observatory on Health Systems and Policies.Google Scholar
Morel, N., Palier, B. and Palme, J. (2012), Towards a Social Investment Welfare State? Ideas, Policies and Challenges, Bristol: The Policy Press.Google Scholar
Morgan, D., Astolfi, R. (In press), ‘The financial impact of the GFC: health care spending across the OECD’, Health Economics, Policy and Law.Google Scholar
Organization for Econonimc Co-Operation and Development (OECD) (2009), Health and the Economic Crisis, Note to Health Committee, Directorate for Employment, Labour and Social Affairs. DELSA/HEA (2009) 1, OECD, 2009.Google Scholar
Organization for Econonimc Co-Operation and Development (OECD) (2010), Health at a Glance: Europe 2010, Paris: OECD.Google Scholar
Paoli, F. (2012), ‘Health systems efficiency and sustainability: a European perspective’, Eurohealth, 18(3): 1417.Google Scholar
Pearson, M. (2012), Financial sustainability and affordability of health care systems. Lessons from OECD countries. OECD.Google Scholar
Sabel, C. F. and Zeitlin, J. (2008), ‘Learning from eperience: the new architecture of experimentalist governance in the EU’, European Law Journal, 14: 271327.Google Scholar
Scharpf, F. W. (1999), Governing in Europe. Effective and Democratic? Oxford: Oxford University Press.CrossRefGoogle Scholar
Schmidt, V. (2013), ‘Speaking to the markets or to the people? A discursive institutionalist analysis of the EU’s sovereign debt crisis’, The British Journal of Politics and International Relations, 16: 188209.Google Scholar
Social Protection Committee (SPC) (2005), Review of preliminary national policy statements on health care and long-term care, http://ec.europe.eu/employment_social/social_protection/dpc/spc_ltc_2005_en.pdf [14 March 2014].Google Scholar