Health Economics, Policy and Law


Supporting health systems in Europe: added value of EU actions?

Timo Clemensa1 c1, Kai Michelsena1 and Helmut Branda1

a1 Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands


Since the start of the economic crisis, the European Union's (EU's) predominant discourse has been austerity and fiscal consolidation. The detrimental effects on Europe's health systems and the health status of its citizens are well described. However, little is known about the emerging EU-level initiatives to support national health systems handle the challenges of efficient care provision and system reorganisation aimed to meet their future needs. This review analyses the manner, conditions and prospects of such EU support. First, health system objectives are increasingly entering the EU health policy agenda. Second, professional and patient mobility provisions may support member states (MS) in copying with crisis related health challenges but can potentially acerbate them at the same time. Third, in recent initiatives health system goals are more closely tied to the EU's economic growth narrative. And fourth, health system issues are taken up in existing EU-level structures for debate and exchange between MS. In addition, the design of some policies may have the potential to intensify socioeconomic and health inequalities rather than ameliorate them.

(Received March 14 2013)

(Revised May 30 2013)

(Accepted July 17 2013)

(Online publication August 22 2013)