The European Union and Health Services

The Impact of the Single European Market on Member States


Busse, R.,
Wismar, M.,
Berman, P.C.

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The European Union and health services do not seem to sit easily together. While most Member State Governments have assumed that they have full responsibility and control over their own health services, on the basis of Article 152 of the Amsterdam Treaty, it is becoming increasingly apparent that the Single European Market is making a substantial impact on health services. Recent rulings by the European Court of Justice (ECJ) have, in particular, established the freedom of citizens to choose health care goods and services across borders.
To examine the actual relationship between the SEM and health services, this book identifies SEM regulations and directives as well as ECJ decisions which explicitly refer to health services and which therefore have a potential impact on the purchasing, supply and delivery of health services, evaluates the impact of SEM regulations and ECJ decisions the purchasing, supply and delivery of health services, and identifies outcomes, including both intended and unintended effects, of the SEM on Member States’ health services and develops futures scenarios exploring key issues identified in the earlier analysis and evaluation. Chapters deal with the labour market for health professionals in the UK, access to health care by tourists in Spain and data protection in Sweden as well as with the freedom of goods and services (the pharmaceutical and medical products markets in Sweden), public procurement of goods and services by health care providers in Spain and consumer choice of goods and services in Germany and other countries.
The evidence convincingly demonstrates that the relationship between health services as a major sector of Member States’ economies and the SEM are intertwined in such a complex manner that it is virtually impossible to separate them. The authors conclude that it is time to raise the profile of health policy at the European Union level – but in a manner consistent with the aspirations of Member States.

Edited on behalf of the European Health Management Association (EHMA) by Reinhard Busse (European Observatory on Health Care Systems), Matthias Wismar (Hannover Medical School, Germany) and Philip Berman (EHMA), the book includes contributions by Pauline Ong and Calum Paton (Keele University, UK), Clas Rehnberg (Centre for Health Economics, Stockholm, Sweden), Barbro Renck and Mona Sundh (Centre for Public Health Research, Karlstad, Sweden), Nuria Romo and Fernando Silio (Andalusian School of Public Health, Granada, Spain).