Solidarity as a Political Determinant of Health: Insights from EU Competition Policy.

CONTEXT

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.

METHODS

A range of EU case law, treaty provisions, and European Commission publications relating to EU competition policy are analyzed.

FINDINGS

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.

CONCLUSIONS

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.