Institute of Political Science, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
Health Policy. 2013 Aug;111(3):226-33. doi: 10.1016/j.healthpol.2013.05.004. Epub 2013 Jun 12.
Despite the fact that Member States and many citizens of the EU like to keep healthcare a foremost national competence and the EU treaties state that Member States remain primarily responsible for the organization and delivery of health care services, the European Union (EU) has expanded its involvement in healthcare policy over the last twenty years. Based on interviews and document and literature analysis we show that the scope of EU involvement has widened from public health and access to care, to quality of care. In this paper we concentrate on the latter. Focusing on the recent EU initiatives regarding the quality systems of the Member States and the quality of services, this paper shows how the depth of EU interference has increased from sharing information to standardization and even to the first signs of enforcement. We argue that at this stage, reflection on the feasibility and desirability of the EU's involvement is clearly needed, also considering the differences in quality of care policies between and within EU Member States. Both arguments in favour and against further EU involvement are discussed in this paper.
尽管欧盟成员国和许多公民喜欢将医疗保健保留为首要的国家职能，并且欧盟条约规定成员国仍然主要负责组织和提供医疗保健服务，但在过去二十年中，欧盟已扩大了其在医疗保健政策方面的参与。基于访谈、文件和文献分析，我们表明，欧盟的参与范围已经从公共卫生和获得医疗保健扩大到了医疗保健质量。本文集中讨论了后者。本文聚焦于欧盟最近针对成员国质量体系和服务质量的举措，展示了欧盟的干预深度如何从信息共享增加到标准化，甚至出现了执行的初步迹象。我们认为，在现阶段，需要对欧盟参与的可行性和可取性进行反思，也要考虑到欧盟成员国之间和内部医疗保健政策质量的差异。本文讨论了支持和反对进一步欧盟参与的论点。
