Gerlinger Thomas, Urban Hans-Jürgen
Institute for Medical Sociology, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Cad Saude Publica. 2007;23 Suppl 2:S133-42. doi: 10.1590/s0102-311x2007001400003.
In the European Union (EU), health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision.
在欧盟(EU),卫生政策和卫生系统的体制改革主要被视为国家事务,因此欧盟内部的医疗保健系统差异很大。然而,卫生政策领域正在经历一个动态的欧洲化进程。这一进程受到朝着更具竞争力的经济方向发展的推动,最近启动的这一方向被称为里斯本战略,而欧洲经济与货币联盟的监管要求也在推动卫生政策的欧洲化。此外,所谓的开放式协调方法,代表了欧洲多层次体系内的一种新监管模式,越来越多地应用于卫生政策领域。因此出现了各种不同的趋势。虽然里斯本战略总体上伴随着卫生政策的战略升级,但卫生政策越来越多地被用于增强经济竞争力。预计对成员国控制成本和促进基于市场的医疗保健服务的压力将会增加。