Health Care And Its Financing In The Single European Market

Health care and its financing will not be harmonized within the European Union (EU). Therefore, the differences between the health systems of the member-states in a Single European Market are gaining in relevance. The process of economic integration also effects health. This book integrates economics, law, social, political and health sciences in the analysis of health care issues in the EU. It covers the development of health systems and policy in the community, the markets for pharmaceuticals and for medical devices, EU-trends in hospital financing, issues in the comparison of financing systems, especially in the field of private expenditures, reforms of health care financing in social security systems and national health services in the EU and cross-border health care between EU member-states. The results feature an up-to date overview on the European dimension of health care and its financing. The book is relevant to experts in health care organizations, policy, industry and research.

While most Member States Governments have assumed that they have full responsibility and control over their own health services it is becoming increasingly apparent that the Single European Market is having 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 on the purchasing, supply and delivery of health services, - identifies outcomes, including both intended and unintended effects, of the SEM on Member States' health services and - develops future scenarios exploring key issues identified in the earlier analysis and evaluation.

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.

Patient mobility across Europe is markedly increasing and new generations will actively ask to be treated by the health-care system that best meets their needs. At a political level, the EU issued the EU Directive no. 24/2011/CE of 9th March 2011 concerning the application of patients’ rights in cross-border health care and has contributed to improving the level of freedom of choice for the European citizen, but it does not seem to have increased actual patient mobility across Europe. Freedom to choose is necessary to grant the people of Europe the same access to public-sector health-care services. The latter is a key instrument for an efficiently functioning “single market” ensuring real mobility within the EU. The aim of this book is to study the current European health care market and discuss the hypothesis of a European right of citizenship with reference to health-care services. It examines patients' mobility from several perspectives: determinants of patient mobility, governance of cross-border mobility at EU level as concerns patients and health-care professionals, policy implications, and case studies. It is intended for health researchers, decision-makers and professionals concerned with health-care provision and patient mobility. The goal is to provide, through scientific and methodological rigor, new informative tools useful for the implementation of new policies in the health-care sector in order to implement effective health-care integration in the European Union.

This book examines the advantages and disadvantages of funding arrangements currently in use across Europe. Adopting a cross-national, cross-dischiplinary perspective, it assesses the relative merits of the main methods of raising resources including taxation; social voluntary and supplemental forms of insurance; and self-pay including co-payments. Chapters review recent evidence and experience in both eastern and western Europe. The volume is introduced by a summary chapter which integrates conceptual issues in funding with an overview of the main advantages and disadvantages of each method of funding drawn from the expert chapters.

No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.

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.