Exploring Health Policy Development In Europe

Countries in Europe have long recognized that good health care, though essential, is not in itself sufficient to improve health or to reduce the increasing gaps in health status between the rich and the poor. In 1984, together with WHO, they adopted and many attempted actively to implement, what has become known as the health for all policy. This called for a radical shift from health services planning to an approach based on setting objectives and targets for health, requiring partnerships with industry, agriculture and commerce and settings such as workplaces and schools. It also required changes in behaviour and action to ensure a fairer distribution of the determinants of health, such as income, education, employment opportunities, and adequate food and housing. This volume provides a broad overview of how the 51 countries in the WHO European Region set about this ambitious task. The study's findings are based on replies to checklists sent to the Member States, a set of country profiles (given as an annex), published policy documents, and case studies written by people who were involved in the process in their own countries or regions. Examining how countries used some of the policy instruments open to them as they strove to close the health gaps, the study explores how far the rhetoric was accompanied by the necessary action and whether countries were able to move from their traditional ways of working, and poses questions as to whether this approach will be sufficient to meet the challenges of the future.

The impact of European integration on diverse national social policies is still largely unknown. While policy decision making remains at the country level, there is a strong possibility that indirectly, as a result of ideological imperatives and financial constraints, policies will change. National health policy is a case in point. This important volume explores the current and probable effect of European integration on health care protection. Will it tend to encourage all European member states to provide equitable and universal access to quality care? Or is the European integration process likely to lead to social exclusion of some? The high degree of social welfare as a health expectancy holds great significance for decisions in countries like the United States facing similiar pressures for expanded coverage. In answering these questions, Panos Minogiannis examines policies in Greece, France, Germany, and the Netherlands. Minogiannis frames his argument through an exploration of the history of the institutionalization of health care. Chapter 1 explores the nature of challenges that health care faces in an era of integration and the ways in which these challenges have emerged. Chapter 2 discusses centralization of governance in Brussels, describing the structure and relations of different European Union institutions, and their interactions with member states. The final portions of the book, through case studies of the Dutch, French, German, and Greek health reforms, explore the history of the political development of health care institutions with a particular interest in reform proposals in the last fifteen years. Chapter 7 brings together lessons from previous chapters and discusses the dynamics of health policy making in the European Union. Minogiannis concludes that health insurance will most likely remain at the member state level as far as politics are concerned, at least for the present, although policy makers will most likely have to deal with the issue of cross-border health more comprehensively than in the past. Those interested in comparative policy, and in particular health care policy, will find this volume highly informative reading. Those interested in the impact of European integration will find it provocative. Panos Minogiannis is with the Mailman School of Public Health at Columbia University and is a research associate at the Eisenhower Center.

Health constitutes a core element of welfare states and a vital nerve in the trust relation between citizen and their governments. Focusing on the health sector, this book analyzes the closely interwoven relationship between the European Union and Member States. The authors explore the dynamic and multi-fold process of de-nationalizing health policies and illustrate how European policies develop in a sector that still appears to be under exclusively national competence. They describe the multiple forms and ways the Europeanization process takes, driven by market integration, public health crises and politics of consumer protection. The authors also provide a detailed analysis of key topics: the pharmaceutical sector, market regulation of medical goods and devices, food safety, the blood provision and plasma industry, European politics on bioethics, and risk reduction in the field of drug abuse. Providing a comprehensive and informed assessment of the Europeanization process in the field of health policies, this book will be of interest to students and scholars of health, European integration and policy-making.

While there may be consensus on the broader issues of the core objectives of the health care system, expectations differ between EU countries, and European national policy-makers. This book seeks firstly to assess the impact of the enlargement process and then to analyse the challenges that lie ahead in the field of health and health policy.

"The impact of European integration on diverse national social policies is still largely unknown. While policy decision making remains at the country level, there is a strong possibility that indirectly, as a result of ideological imperatives and financial constraints, policies will change. National health policy is a case in point. This important volume explores the current and probable effect of European integration on health care protection. Will it tend to encourage all European member states to provide equitable and universal access to quality care? Or is the European integration process likely to lead to social exclusion of some? The high degree of social welfare as a health expectancy holds great significance for decisions in countries like the United States facing similiar pressures for expanded coverage. In answering these questions, Panos Minogiannis examines policies in Greece, France, Germany, and the Netherlands. Minogiannis frames his argument through an exploration of the history of the institutionalization of health care. Chapter 1 explores the nature of challenges that health care faces in an era of integration and the ways in which these challenges have emerged. Chapter 2 discusses centralization of governance in Brussels, describing the structure and relations of different European Union institutions, and their interactions with member states. The final portions of the book, through case studies of the Dutch, French, German, and Greek health reforms, explore the history of the political development of health care institutions with a particular interest in reform proposals in the last fifteen years. Chapter 7 brings together lessons from previous chapters and discusses the dynamics of health policy making in the European Union. Minogiannis concludes that health insurance will most likely remain at the member state level as far as politics are concerned, at least for the present, although policy makers will most likely have to deal with the issue of cross-border health more comprehensively than in the past. Those interested in comparative policy, and in particular health care policy, will find this volume highly informative reading. Those interested in the impact of European integration will find it provocative. Panos Minogiannis is with the Mailman School of Public Health at Columbia University and is a research associate at the Eisenhower Center."--Provided by publisher.

People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.

This book draws on research within neo-Weberian and neo-institutionalist perspectives to critically analyse National Health Services (NHSs) in Western Europe. Exploring the challenges posed by neo-liberal policies, it also looks at the impact of the role of the state, the medical profession, the public and the medical–industrial complex in their development. Bringing together a top-line range of expert international contributors, this book includes national studies from three European macro-regions: Britain, Scandinavia and the Mediterranean. In the first part, the NHSs of each country considered are examined historically and in a contemporary context in face of emerging challenges – from cost containment to governance. The second part looks across the macro-regions at the influence of the main actors involved in their evolution and sustainability. Comparing and contrasting the NHSs of Western Europe, the book ends with a discussion of future directions. This book makes a vital contribution at a time when health services globally have been under great pressure in the wake of the COVID-19 pandemic. It is written for academics and advanced students of healthcare, management, public policy, social policy and sociology – in addition to health professionals and policymakers.