Competition in EU Health Law and Policy – What Role for Member States?

For our first event of this semester our guest, Dr. Mary Guy, comes to us from Lancaster University to discuss her work on EU Health Law and Policy. Where are we heading? What role is left for member states? And how are we to understand the changes? Specifically Dr Guy will be presenting her latest research which builds on her book Competition Policy in Healthcare: Frontiers in Insurance-based and Taxation-funded Systems and includes the very latest developments:

“Article 168(7) TFEU has been described as a “subsidiarity clause for healthcare” for circumscribing EU-level intervention in Member States’ responsibilities regarding the organisation and delivery of health services.

While Article 168(7) TFEU suggests that Member States are free to experiment with competition reforms to varying degrees (Andreangeli 2016), expanded public/private delivery of healthcare services is likely to trigger application of EU competition rules. 

The EU competition law framework which has emerged thus far from cases such as Ambulanz Glöckner, AOK Bundesverband and FENIN, has influenced competition reforms at a national level (Guy 2019) and led to suggestions that EU-level intervention is at least desirable to avoid divergent interpretations of EU competition law (Van de Gronden and Szyszczak 2014).

EU-level influence and intervention regarding competition reforms of national healthcare systems may now be expanding via the fiscal control mechanisms of the European Semester, specifically the Country-Specific Recommendations (CSRs), and it is increasingly established that healthcare-related CSRs are influential (Azzopardi-Muscat et al. 2015, DGSANTE 2019).

The CSRs have prompted Member States, inter alia, to remove restrictions on healthcare professions (France 2015) and increase competition (Italy 2016). The fundamental tension between solidarity and competition associated with national healthcare reforms has also been reflected in CSRs to improve cost-effectiveness and equal access (Finland 2018).

This paper employs an interdisciplinary (law/political science) approach to examine possible limits of Article 168(7) TFEU by reference to the development of competition reforms in healthcare – a lens which reflects possible wider movement in EU focus between completion of the internal market and fiscal policy, considered to represent two “faces” of EU health policy (Greer 2013). This lens is also useful for examining how the EU may seek to ensure better implementation of EU policies at national level, and the extent to which EU fiscal policy may influence national healthcare reform.

At least two important considerations emerge. Firstly, that the Member States receiving CSRs may be less “free” under Article 168(7) TFEU to experiment with healthcare system reform than those which do not. Secondly, that Member State-level insights may result in a more coherent EU-level approach to competition in healthcare.”

We look forward to seeing you there. Refreshments will be served.

4 March 2020, 16:00-18:00, Old College – G.158 – Quad Teaching Room