EU Law and Healthcare Services - Normative Approaches to Public Health systems

In the European Union, as in modern developed economies generally, the preponderant model of health care is built on a complicated triangular relationship among providers, the State as a funding body, and patients, the regulation of which varies depending on each Member State and its healthcare system. Focusing on the EU legal mechanisms that have been developed for the scrutiny of this triangular relationship, this book examines the extent to which the market imperatives that have been introduced in recent decades can actually influence, remodel, alter, unify, or fragment the national provision of health care services across the EU. In the process, the author exposes a normative nucleus that cannot be torn apart by the internal market mandate, and shows that this nucleus mirrors the hallmarks of a truly European healthcare system. Among much else, the analysis covers all the following issues and topics: - benefit-in-kind v. reimbursement and their amalgamations; - if and how Member States can ring-fence their health systems and to what extent they can do so; - patient mobility; - social security coordination and the de-territorialization of health care; - effect of the EU common commercial policy; - roles of the General Agreement on Trade in Services (GATS) and the Transatlantic Trade and Investment Partnership (TTIP); - queue-jumping and resort to the most efficient provider; - valuing waiting time for treatment and the notion of ‘undue delay’; - prior authorization schemes as the gatekeepers of territoriality; - rules governing the engagement of commercial operators; and - regulatory prerequisites for contracting out of healthcare services. The analysis draws on a wide range of sources and materials, including public health economics and public health policy literature, case law of the European Court of Justice and the General Court, EU secondary legislation, soft law instruments of the EU institutions, and relevant legal scholarship. Practitioners, jurists, and academics in healthcare law will greatly appreciate the numerous innovative insights the author brings to the field, notably the emphasis on the dynamics of supply and demand and the masterful elucidation of the underlying conflicts between economic policy and social protection. This book takes a giant step towards bringing the frequently invoked criteria of universality, access to good quality care, equity, and solidarity to the fore, and for this reason is sure to make its mark on healthcare law in Europe.

Preface. List of Abbreviations. Acknowledgements. Introduction. PART I Unravelling the Demand Side of Public Health Systems: The Patient as a Worker or as a Consumer? CHAPTER 1 Healthcare as a Benefit under Social Security Coordination and the Worker as a Patient. CHAPTER 2 Healthcare as a Service under Article 56 TFEU and the Patient as a Consumer. CHAPTER 3 The Patients’ Mobility Case Law Acquis as a Source of Silent Harmonization. CHAPTER 4 Healthcare Provision for the (Migrant) Patient on the Basis of Secondary Law: From Coordination to Harmonization or Both? PART II Unravelling the ‘Supply Side’ of Public Health Systems: The Regulatory and Redistributory State under EU Law. CHAPTER 5 The Regulatory State and the Free Establishment of Healthcare Providers. CHAPTER 6 The State as Insurer and/or Purchaser of Healthcare and the Rules on Competition Conclusions. I The Way so Far. II The Way Forward. Bibliography. Table of Cases. Table of Legislation and Other Instruments. Index.