On thin ice: EU health policy and politics

Abstract

Abstract European Union (EU) health policy debate is in a peculiar stage: on the one hand, there is an established community of EU health policy experts who understand that a broad range of EU policies that might have major consequences for health care systems. On the other hand, there are the many managers and policymakers around the EU who know little about EU health policy and have seen few or no effects. I argue that it is because EU health policymaking has slow effects, and that the challenge is in influencing it before it has had important consequences. This article first reviews the policy issues, explaining why so much EU policy activity has produced so little concrete effect - and why that situation will probably change. The establishment of a EU role in health care policy means that influence now will shape policies in the future. The second half of the article analyses the problems of coordination and attention that interfere with health care systems’ ability to identify the important issues. It argues that the problems are not so much in the management of complex knowledge as in the politics of knowledge: different interests that are contending for control over the future of EU health policy.