Revived Europeanisation? Governing Health in the Post-crisis EU

Eleanor Brooks

In the post-crisis era, the EU has strengthened its governance of economic policies in member states, establishing instruments that target national public policies from a finance and sustainability perspective. The degree of intervention into national administrations now reflects that experienced by developing countries in receipt of World Bank or IMF loans for structural adjustment, and extends into areas reserved in the EU's founding treaties as exclusive member state competences. This paper uses the case of health policy to argue that the strengthened economic governance framework has provided the EU with a new set of tools and increased leverage with which to prompt or revive Europeanisation in previously 'out of bounds' policy areas. Based on interviews conducted with Brussels-based policy-makers and academics, it compares the Europeanisation of health systems in member states facing different levels of pressure - determined by their financial situation and dependence upon EU funds - across the continent. It finds that the power of economic governance instruments is considerable and that, as a result, the factors which determine Europeanisation are no longer found solely in the governance of national administrations, but in their degree of dependence and financial status. This new dimension affects both 'new' and 'old' member states, challenging the established models of 'goodness of fit' and national adaption and, as such, warrants further exploration as part of a revived Europeanisation research agenda.

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