Health law and policy in the European Union

University of Michigan, Ann Arbor, MI, USA.
The Lancet (Impact Factor: 45.22). 03/2013; 381(9872). DOI: 10.1016/S0140-6736(12)62083-2
Source: PubMed

ABSTRACT From its origins as six western European countries coming together to reduce trade barriers, the European Union (EU) has expanded, both geographically and in the scope of its actions, to become an important supranational body whose policies affect almost all aspects of the lives of its citizens. This influence extends to health and health services. The EU's formal responsibilities in health and health services are limited in scope, but, it has substantial indirect influence on them. In this paper, we describe the institutions of the EU, its legislative process, and the nature of European law as it affects free movement of the goods, people, and services that affect health or are necessary to deliver health care. We show how the influence of the EU goes far beyond the activities that are most visible to health professionals, such as research funding and public health programmes, and involves an extensive body of legislation that affects almost every aspect of health and health care.

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    • "However, in times of financial constraint, policy discussions often circle around cutting back social protection expenditures. Only four European Union member states (Netherlands, France, Portugal, and Spain) offered undocumented migrants access to primary care [131,152,153], but recent reductions in health expenditures pose severe threats and lead to decisions limiting healthcare to migrants without sufficiently investigating the impacts on those in need [153]. A reduction in access to primary and specialist care is indeed unlikely to be cost-effective, as use of emergency services will increase [157,158]. "
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    ABSTRACT: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
    Journal of Hypertension 02/2014; 32(5). DOI:10.1097/HJH.0000000000000125 · 4.22 Impact Factor
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    • "EU involvement in shaping health policy in Poland was another result of this. EU law and policies affect many aspects of health policy, such as mobility (of pharmaceuticals, patients, and medical professionals), research funding, public debate, and public health policies [Greer 2013]. The state's role with respect to health is thus infl uenced by EU regulations, and this infl uence requires further research. "
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    ABSTRACT: The article discusses the medical travel (medical tourism) of Polish women migrants based on a study conducted between 2008 and 2011 on Polish women who migrated to London, Barcelona, and Berlin. The author argues that the principal reasons for medical travel to Poland are the lower costs of private treatment, the relatively easy access to specialised health care, and personal comfort derived from linguistic and cultural competency. The women in the study who travelled to Poland for medical treatment combined the economic resources acquired while living abroad with their knowledge of the cultural and medical system in Poland to choose the best options for them. The treatments they sought included gynaecological, dental, and other specialised treatments, for which they turned to the private health sector in Poland. Some of the women also sought treatment in other countries. The women in the study highlighted the advantages of medical travel and mobility while also reflected on the dilemmas they faced in choosing the best care. The author argues that medical travel poses a challenge to the national borders of health-care systems and the national availability of medical procedures, and found that while such mobility generates inequalities it also leads to greater agency and creativeness on the part of patients when they challenge the given regulations, authority, and expert knowledge in one country.
    Sociologický časopis 01/2014; 50(6):897. DOI:10.13060/00380288.2014.50.6.147 · 0.36 Impact Factor
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    • "This finding is corroborated by the literature on the potential of new governance instruments for health- and social policy-making at EU-level [11,52-54]. However, these new governance instruments can also be regarded as a rather strategic investment of the EC to keep topics on the agenda until a political window of opportunity opens but as an ineffective policy tool to enforce and implement action in due course [6]. The collaboration of a diverse set of stakeholders as it is the case for example in the EU Platform for Action on Diet, Physical Activity and Health can lead to actions that constitute rather a compromise of various interests. "
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    ABSTRACT: The European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity. Semi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs. The ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients' rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity. When comparing the emerging themes from the interviews conducted with the responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development.
    BMC Public Health 11/2013; 13(1):1074. DOI:10.1186/1471-2458-13-1074 · 2.32 Impact Factor
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