Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Health Econ Policy Law. 2014 Jan;9(1):49-69. doi: 10.1017/S1744133113000273. Epub 2013 Aug 22.
Since the start of the economic crisis, the European Union's (EU's) predominant discourse has been austerity and fiscal consolidation. The detrimental effects on Europe's health systems and the health status of its citizens are well described. However, little is known about the emerging EU-level initiatives to support national health systems handle the challenges of efficient care provision and system reorganisation aimed to meet their future needs. This review analyses the manner, conditions and prospects of such EU support. First, health system objectives are increasingly entering the EU health policy agenda. Second, professional and patient mobility provisions may support member states (MS) in copying with crisis related health challenges but can potentially acerbate them at the same time. Third, in recent initiatives health system goals are more closely tied to the EU's economic growth narrative. And fourth, health system issues are taken up in existing EU-level structures for debate and exchange between MS. In addition, the design of some policies may have the potential to intensify socioeconomic and health inequalities rather than ameliorate them.
自经济危机开始以来,欧盟(EU)的主要论调一直是紧缩和财政整顿。欧洲卫生系统及其公民健康状况所受到的不利影响已有详细描述。然而,对于欧盟为支持各国卫生系统应对有效提供护理和系统重组以满足未来需求方面的挑战而采取的新兴欧盟层面的举措,人们知之甚少。本综述分析了这种欧盟支持的方式、条件和前景。首先,卫生系统目标越来越多地纳入欧盟卫生政策议程。其次,专业人员和患者流动规定可能会支持成员国(MS)应对与危机相关的卫生挑战,但同时也可能加剧这些挑战。第三,在最近的举措中,卫生系统目标与欧盟的经济增长叙述更加紧密地联系在一起。第四,卫生系统问题在现有的欧盟层面结构中进行辩论和成员国之间的交流。此外,一些政策的设计可能有加剧社会经济和健康不平等的潜力,而不是改善这些不平等。