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Swimming Upstream: Health Policy and the Reform of EU Economic Governance

Eleanor Brooks

The organisation and financing of health systems is a fiercely guarded area of member state competence, guaranteed under Article 168 TFEU. The recent wave of economic governance reforms, however, has seen health increasingly referenced within the context of broader macroeconomic policies and frameworks such as the Annual Growth Survey, which outlines policy recommendations on national achievement of the Europe 2020 goals. Furthermore, the involvement of the EU in the sustainability of health systems is not confined to emergency measures in the face of crisis – it is becoming an integral part of the EU’s strategy for growth through better economic governance. Decisions made upstream by EU finance and economic ministers, through processes such as the European Semester, are significantly delimiting the policy options available to national health policy-makers via control of budgetary expenditure. Guided by interviews with high-level policy-makers and officials, this study will ask whether we are witnessing the beginning of a strengthened European competence for health and explore the potential response of member states to such unprecedented EU influence in the organisation and finance of national health systems.

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