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Does European Integration of Health Policy only Benefit a Small Minority of Mobile Individuals while it Endangers Collective Institutions that Protect the Majority at the National Level?

Angelika Schenk

During the past 15 years, there has been a rapid increase in EU free movement law relating to healthcare despite EU law explicitly excluding any harmonisation of national healthcare systems. This development is mostly visible in ECJ case law, which has increasingly promoted patient mobility and the application of competition law in healthcare based on grounds of market integration.However, the traditional territoriality principle in healthcare makes this Europeanisation trend appear particularly puzzling. Historically, social insurance had been rooted in national boundaries for optimally ensuring its relevant aims, namely solidarity, equity, efficiency and universality. Also, even though there has been some increase in 'health-tourism' lately, the number of mobile individuals in the EU is rather small: only 2.5 percent EU citizens currently live in another Member State.The consequent conflict between Member States providing healthcare based on solidarity and EU bodies mainly seeking market freedom seems obvious. Thus, this paper will show that even though not only few mobile individuals benefit from healthcare integration, national room for manoeuvre in healthcare policy has sharply been restricted. The success of further European healthcare integration will finally depend on the extent to which the EU achieves counterbalancing market integration and social security protection.

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