Liverpool John Moores University.
J Health Polit Policy Law. 2024 Oct 1;49(5):783-803. doi: 10.1215/03616878-11257016.
The connection between law and political determinants of health is not well understood, but nevertheless it is suggested that the two are inseparable, and this represents an upstream level with scope for influencing other determinants of health (particularly social determinants). Solidarity underpins European health care systems, and given its clear link with redistribution, it can be seen as a means for addressing health inequities. As such, solidarity may be seen as a political determinant of health in the specific context of European Union (EU) competition policy.
A range of EU case law, treaty provisions, and European Commission publications relating to EU competition policy are analyzed.
Solidarity is typically juxtaposed as antithetical to competition and thus as underpinning exceptions to the applicability of prohibitions on anticompetitive agreements, abuse of dominance, and state aid. Case law indicates an additional dynamic between definitions of solidarity at the EU and national levels.
This analysis leads to two groups of considerations when framing solidarity as a political determinant of health in the EU competition policy context: first, the predominance of solidarity suggests it may shape competition reforms; second, the EU-member state dynamic indicates less EU-level reach into national competition reforms in health care than may be expected.
法律与健康的政治决定因素之间的关系尚未得到很好的理解，但尽管如此，有人认为两者是不可分割的，这代表了一个具有影响其他健康决定因素（特别是社会决定因素）的潜力的上游水平。团结是欧洲医疗保健系统的基础，鉴于它与再分配的明确联系，团结可以被视为解决健康不平等的一种手段。因此，团结可以被视为欧盟（EU）竞争政策具体背景下的一个健康的政治决定因素。
分析了一系列与欧盟竞争政策相关的欧盟判例法、条约规定和欧盟委员会出版物。
团结通常被视为与竞争相对立，因此是对禁止竞争协议、滥用支配地位和国家援助的适用的例外的基础。判例法表明，欧盟和国家层面上的团结定义之间存在着一种额外的动态关系。
当将团结作为欧盟竞争政策背景下的健康的政治决定因素时，这种分析导致了两组考虑因素：首先，团结的主导地位表明它可能会影响竞争改革；其次，欧盟成员国的动态表明，在医疗保健方面，欧盟对国家竞争改革的影响程度可能低于预期。
