Amsterdam Centre of European Studies, University of Amsterdam, Amsterdam, Netherlands.
Faculty of Economics and Business, University of Amsterdam, Amsterdam, Netherlands.
Eur J Public Health. 2021 Apr 24;31(2):253-258. doi: 10.1093/eurpub/ckaa201.
The COVID-19 outbreak has heightened ongoing political debate about the international joint procurement of medicines and medical countermeasures. The European Union (EU) has developed what remains largely contractual and decentralized international procurement cooperation. The corona crisis has broadened and deepened public debate on such cooperation, in particular on the scope of cooperation, solidarity in the allocation of such cooperation, and delegation of cooperative decision-making. Crucial to political debate about these issues are public attitudes that constrain and undergird international cooperation.
Our survey includes a randomized survey experiment (conjoint analysis) on a representative sample in five European countries in March 2020, informed by legal and policy debate on medical cooperation. Respondents choose and rate policy packages containing randomized mixes of policy attributes with respect to the scope of medicines covered, the solidarity in conferring priority access and the level of delegation.
In all country populations surveyed, the experiment reveals considerable popular support for European cooperation. Significant majorities preferred cooperation packages with greater rather than less scope of medicines regulated; with priority given to most in-need countries; and with delegation to EU-level rather than national expertise.
Joint procurement raises delicate questions with regard to its scope, the inclusion of cross-border solidarity and the delegation of decision-making, that explain reluctance toward joint procurement among political decision-makers. This research shows that there is considerable public support across different countries in favor of centralization, i.e. a large scope and solidarity in the allocation and delegation of decision-making.
COVID-19 疫情加剧了关于药品和医疗对策国际联合采购的持续政治辩论。欧盟（EU）制定了在很大程度上仍然是契约性和分散性的国际采购合作。这场新冠危机扩大和深化了关于这种合作的公众辩论，特别是关于合作的范围、这种合作分配中的团结以及合作决策的授权。关于这些问题的政治辩论的关键是限制和支持国际合作的公众态度。
我们的调查包括在 2020 年 3 月对五个欧洲国家的代表性样本进行的随机调查实验（联合分析），该实验以关于医疗合作的法律和政策辩论为依据。受访者选择并对政策方案进行评分，这些方案包含了有关药品覆盖范围、赋予优先准入的团结程度和授权程度的政策属性的随机组合。
在所调查的所有国家人口中，实验表明，人们对欧洲合作有相当大的支持。绝大多数人更喜欢合作方案，认为药品监管范围越大越好；优先考虑最需要的国家；并将决策权授权给欧盟层面而不是国家专业知识。
联合采购在其范围、跨境团结的纳入以及决策的授权方面引发了微妙的问题，这解释了政治决策者对联合采购的不情愿。这项研究表明，不同国家的公众对集中化有相当大的支持，即分配和决策授权方面的广泛范围和团结。
