European Integration and Health Policy The Artful Dance of Economics and History

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.