1 - Health systems governance in Europe: the role of European Union law and policy

Summary

The scope and aims of this book

This volume assesses the impact of European Union (EU) policy and law on Member States’ health systems and their governance in a number of key areas. In so doing, it builds on two earlier books that sought to assess the changing legal and policy dynamics for health care in the wake of the European Court of Justice's (ECJ) seminal rulings in the Kohll and Decker cases. These books showed that, despite widely held views to the contrary, national health care systems in the EU were not as shielded from the influence of EU law as originally thought. The explicit stipulations of Article 152 EC (as amended by the Amsterdam Treaty) that health is an area of specific Member State competence, and implicit understanding of the subsidiarity principle where policy is undertaken at the lowest level appropriate to its effective implementation, proved not to be the ‘guarantees’ of no EU interference in national health care services that they were often held to be. As the raft of legal cases and degree of academic attention that followed have shown, Kohll and Decker were certainly not the ‘one-offs’ many policy-makers hoped they would be. In fact, they are widely held to have set precedent in terms of the application of market-related rules to health care, which in turn ‘allowed the EU into’ the health care arena.