Contents
THE AUTHORS
ABSAM HEALTH POLICIES CENTRE
FOREWORD
ABBREVIATIONS
CHAPTER 1
A TRANSNATIONAL ORGANISATION: THE EUROPEAN UNION
1.1. Introduction
1.2. European Union
1.3. Objectives, Aims and Reasons for Establishment of the European Union
1.4. Core Values of the European Union
1.5. The Development, Enlargement and Deepening Process of the European Union
1.5.1. (Historical) Development of the European Union: Legal Basis
1.5.1.1. First Attempts
1.5.1.1.1. European Coal and Steel Community: Treaty of Paris
1.5.1.1.2. European Defence Community
1.5.1.1.3. Western European Union
1.5.1.1.4. European Economic Community and European Atomic Energy Community: Treaty of Rome
1.5.1.1.5. Gathering Organs Under One Roof: The Fusion Treaty
1.5.1.1.6. Towards the Internal Market: The Single European Bill
1.5.1.2. Initiatives After 1990
1.5.1.2.1. Treaty on European Union: Treaty of Maastricht
1.5.1.2.2 Treaty of Amsterdam
1.5.1.2.3. Treaty of Nice
1.5.1.2.4. Constitutional Treaty: The European Constitution
1.5.1.2.5. Treaty of Lisbon: Treaty on the Reform of the European Union
1.5.2. European Union Enlargement Process: Geographical Enlargement – Participation of Countries
1.5.2.1. Candidacy and Accession Process to the European Union
1.5.2.1.1. Membership Applications
1.5.2.1.2. Criteria for Accession to the European Union
1.5.2.1.3. Pre-Accession Strategies and Key Elements
1.5.2.1.4. Accession Negotiations
1.6. The European Union Integration Forms
1.6.1. Free Trade Zone
1.6.2. Customs union
1.6.3. Common Market
1.6.4. Economic Union
1.6.5. Political Union – Full Economic Integration
1.7. Bodies and Institutional Structure of the European Union
1.7.1. European Summit
1.7.2. Council of the European Union: Voice of Member States
1.7.3. European Union Commission
1.7.4. The European Parliament: The Voice of the European Citizens
1.7.5. Economic and Social Committee
1.7.6. Committee of the Regions
1.7.7. Court of Justice of the European Union
1.8. Community Legislation
1.8.1. Primary Legislation
1.8.2. Secondary Legislation
1.8.2.1. Regulations
1.8.2.2. Directives
1.8.2.3. Decisions
1.8.2.4. Recommendations and Opinions
1.8.3. Case Law
CHAPTER 2
THE SOCIAL DIMENSION OF THE EUROPEAN UNION:
THE EUROPEAN SOCIAL MODEL, EUROPEAN UNION SOCIAL MODEL AND EUROPEAN UNION SOCIAL POLICIES AND HEALTH
2.1. Introduction
2.2. European Social Model and European Union Social Model
2.2.1. The Development and Challenges of the European Welfare State
2.2.2. Welfare State Models
2.2.2.1. Anglo – Saxon (Liberal) Model
2.2.2.2. Continental European (Corporatist) Model
2.2.2.3. Scandinavian (Social – Democrat) Model
2.3. European Union Social Policies and Development
2.3.1. European Union Social Policy Elements
2.3.1.1. Free Movement of Labour
2.3.1.2. Worker’s health and work safety
2.3.1.3. Social Dialogue
2.3.1.4. Right of Settlement and Freedom to Provide Services
2.3.1.5. Equal Treatment of the Gender (Equal Treatment of Men and Women)
2.3.1.6. Maintaining the Continuity of the Business Relationship
2.3.1.7. Participation of Workers in the Management of the Enterprise
2.3.1.8. Social Security and Social Exclusion
2.3.2. European Union Financing Mechanisms and Social Policy: European Social Fund and Others
2.4. European Social Model, European Union Social Model, European Union Social Policies and Health
CHAPTER 3
EUROPEAN UNION, HEALTH AND HEALTH POLICIES
3.1. Introduction
3.2. Reasons for Considering Health at European Union Level
3.3. Objectives of the European Union Health Policy
3.3.1. Long Term Goals of the European Union in the Field of Health: Accessibility, Quality and Sustainability
3.3.1.1. Accessibility to Health Services
3.3.1.2. Quality in Health Services
3.3.1.3. Financial Sustainability in Healthcare
3.4. The Basic Principles on which the European Union Health Policy is Based
3.4.1. The Prudence Principle
3.4.2. Substitution Policy
3.4.3. European Value Added Principle
3.4.4. Transparent Coordination Method Principle
3.4.5. Principle of proportionality
3.4.6. European Common Values and Principles
3.4.6.1. Common values
3.4.6.1.1. Solidarity
3.4.6.1.2. Fairness
3.4.6.1.3. Covering Everyone
3.4.6.1.4. Access to Health Services
3.4.6.2. Principles
3.4.6.2.1. Quality
3.4.6.2.2. Sustainability
3.4.6.2.3. Security
3.4.6.2.4. Evidence and Ethical Care Service
3.4.6.2.5. Patient Engagement
3.4.6.2.6. Seeking Your Right
3.4.6.2.7. Privacy and Privacy
3.5. Roles and Responsibilities of the European Union on Health
3.6. Factors Influencing the Development of European Union Health Policy
3.7. Development of European Union Health Policy and Evolution Process
3.7.1. The (Historical) Development of the European Union Health Policy: An Evaluation Specific to the Treaties
3.7.1.1. First Attempts: The Failure of the White Pool
3.7.1.2. First Treaties
3.7.1.2.1. Treaty of Paris 1952
3.7.1.2.2. Treaty of Rome 1957
3.7.1.2.3. Single European Act 1987
3.7.3. Developments and Treaties After 1990
3.7.3.1. Treaty of Maastricht: Treaty on European Union 1993
3.7.3.2. Treaty of Amsterdam 1997
3.7.3.3. Nice Treaty and Health Policy 2001
3.7.3.4. The Constitution and the Convention: Studies in the Future of Europe and Health
3.7.3.4.1. The Structure and Issues of the European Convention
3.7.3.4.2. European Convention, Constitution and Health
3.7.3.4.3. The Place of Health in the Constitutional Treaty
3.7.3.5. Treaty of Lisbon: European Union Reform Treaty 2007
3.7.3.5.1. European Union Charter of Fundamental Rights and Health Policies
3.7.4. Seeking Cooperation among Member States in Health Services
3.7.4.1. The Malaga Process: The Europe of Health
3.7.4.2. High Level Reflection Process
3.7.4.3. Commission’s Reaction: Commission Statements 2004 – Global Strategy for Health Systems
3.7.5. European Union Health Strategies, Statements, Policy Decisions and Health Action Programs
3.7.5.1. Resolution of the Council on Basic Health Policy Preferences 1991
3.7.5.2. Framework Statement for a Program of Action in the Field of Public Health 1993
3.7.5.3. New Public Health Action Program Public Health Action Programs Conducted Before 2003-2008
3.7.5.3.1. Fighting Cancer – Europe Against Cancer
3.7.5.3.2. Health Monitoring, Protection and Promotion
3.7.5.3.3. Fighting Some Infectious Diseases and AIDS
3.7.5.3.4. Combating Substance Abuse
3.7.5.3.5. Prevention of Injuries
3.7.5.3.6. Rare Diseases
3.7.5.3.7. Pollution Related Diseases
3.7.5.4. Communication on the Development of Community Public Health Policy 1998
3.7.5.5. Community Health Strategy Statement 2000
3.7.5.6. Community Public Health Action Programme 2003-2008
3.7.5.6.1. Three Main Components of the New Public Health Action Program
3.7.5.7. Commission Health Work Plans
3.7.5.7.1. Work Plan 2003
3.7.5.7.2. Work Plan 2004
3.7.5.7.3. Work Plan 2008
3.7.5.8. Health and Consumer Protection Strategy and Action Programme 2007-2013
3.7.5.9. White Paper: Together for Health – A Strategic Approach for the EU 2008-2013
3.7.3.9.1. Basic Principles for European Community Action on Health
3.7.5.10. Health Action Programme 2008-2013
3.7.5.11. Third Health ProgramME: Health for Growth Program 2014-2020
3.8. Health Organization in the European Union
3.8.1. Possible Organizational Solutions to the Commission in the Past
3.8.1.1. Option 1: A New Headquarters for Health
3.8.1.2. Option 2: Possible Integration with GM 11
3.8.1.3. Option 3: The Clutter Option
3.8.1.4. Option 4: Integrated Model
3.8.1.5. Option 5: Possible Merger with GM 24
3.8.2. Health-Related Institutions and Actors in the European Union
3.8.2.1. Institutional European Union Actors
3.8.2.1.1. European Union Health Council
3.8.2.1.2. European Parliament Committee on Environment, Public Health and Consumer Policy
3.8.2.1.3. European Commission General Directorate of Health and Consumers
3.8.2.1.4. Committee of the Regions
3.8.2.1.5. Economic and Social Committee
3.8.2.2. Community Agencies and Other Agencies for Health
3.8.2.2.1. European Medicines Agency
3.8.2.2.2. European Environment Agency
3.8.2.2.3. European Agency for Occupational Health and Safety
3.8.2.2.4. European Food Safety Authority
3.8.2.2.5. Public Health High Level Committee
3.8.2.2.6. Interservice Health Group
3.8.2.2.7. European Foundation for the Improvement of Working and Living Conditions
3.8.2.2.8. European Monitoring Centre for Drugs and Drug Addiction
3.8.2.2.9. European Network for Infectious Disease Control and Epidemiological Surveillance
3.8.2.2.10. European Centre for Disease Prevention and Control
3.8.2.2.11. Food and Veterinary Office
3.8.2.2.12. Health Services High Level Group
3.8.2.2.13. Consumers, Health, Agriculture and Food Management Agency
3.8.2.2.14. Community Plant Diversity Office
3.8.2.2.15. Advisory Groups and Platforms for Action
3.9. Health Policy Formation and Decision Making Process in the European Union 190
3.9.1. Forms of European Union Health Policy
3.9.1.1. Creating a Direct (Direct Way) Health Policy
3.9.1.2. Creating an Indirect Health Policy
3.9.1.3. Unplanned Health Policy Creation
3.9.2. Common Qualities in Making European Union Policies
3.9.2.1. Triple Institutional Structure
3.9.2.2. Policy Making Through Litigation: European Court of Justice
3.9.3. Health Policy-Specific Attributes
3.9.3.1. Agenda and Policy-Setting Role of the Council Presidency: EU Presidencies
3.9.3.1.1. UK Presidency (1 January – 30 June 1998)
3.9.3.1.2. Presidency of Luxembourg (1 January – 30 June 2005)
3.9.3.1.3. Belgian Presidency (1 July – 31 December 2010)
3.9.3.2. Tripartite Presidency: Italy, Latvia and Luxembourg (1 July 2014- 31 December 2015)
3.9.3.2.1. Presidency of Italy (1 July 2014- 1 December 2014)
3.9.3.3. The Role of the European Health Policy Forum in Health Policy Making
3.10. European Union, International Cooperation and Health Policies
3.10.1. EFTA/EEA and Associated Countries
3.10.2. Third Countries: “North Dimension”
3.10.3. International Organizations
3.10.3.1. world Health Organization
3.10.3.2. Council of Europe
3.10.3.3. OECD
3.11. Possible Scenarios for the Future of Health Policies and Systems in the European Union
3.11.1. Maintaining the Current Situation
3.11.2. Harmonization of National Health Systems
3.11.3. Deregulation
3.11.4. Synchronizing National Health Systems: The Middle Way
3.12. Common Characteristics of European Union Health Systems and Policies
3.13. Common Challenges Faced by European Union Health Systems and Policies
CHAPTER 4
EUROPEAN UNION INTERNAL MARKET AND HEALTH
4.1. Introduction
4.2. Free Movement and Health Services in the European Union
4.2.1. Free Movement of Persons
4.2.1.1. Free Movement of Patients
4.2.1.1.1. Factors Determining Free Movement of Patients
4.2.1.1.2. How Patients Benefit from Health Services in the European Union
4.2.1.2. Free Movement of Healthcare Professionals
4.2.1.2.1. Factors Determining Free Movement of Healthcare Professionals
4.2.1.2.2. European Union Legislation Regulating the Free Movement of Healthcare Professionals
4.2.1.2.3. Free Movement of Healthcare Professionals in Practice
4.2.1.2.4. Potential Effects of Free Movement of Healthcare Professionals on Health Services
4.2.2. Free Movement of Goods
4.2.2.1. Europeanization of Pharmaceuticals and Medical Devices Policies
4.2.2.1.1. Medicines
4.2.2.1.2. Medical Devices
4.2.2.2. Market Surveillance and Inspection
4.2.2.3. Limitation of Trade in Goods on the Basis of Public Health
4.2.3. Free Movement of Services
4.2.3.1. Service Description in the European Union
4.2.3.2. Right of Settlement
4.2.3.3. Free Movement of Healthcare Providers
4.2.3.4. Free Movement of Insurance Services
4.2.3.4.1. Non-Life (Not Related to Life) Insurance Directives
4.2.4. Free Movement of Capital
CHAPTER 5
OTHER POLICIES OF THE EUROPEAN UNION AND HEALTH: HEALTH IN ALL POLICIES
5.1. Introduction
5.2. European Union Environmental Policy and Health
5.3. European Union Transport Policy and Health
5.4. European Union Public Procurement and Health Systems
5.4.1. What is Public Procurement?
5.4.2. European Union Public Procurement and Public Procurement Policy
5.5. European Union Common Agricultural Policy and Health
5.6. European Working Time Directive and Health Policy
5.6.1. Fate of the Directive: Revision of the Directive and the Positions of the Commission, Council and Parliament on the Directive
5.6.1.1. Derogation Status
5.6.1.2.Working On Call
5.6.1.3. Reference Periods
5.6.1.4. Family Life
5.7. European Union Competition Policy and Health Systems
5.8. European Union Information Society Policy and Health: e-Europe and e-Health
5.8.1. European Union Electronic Health Card
5.8.2. Health Information Networks
5.8.3. Online Health Services
5.8.4. New E-Health Notice
5.9. Common European Currency (Euro) and Health
5.10. The New Enlargement Process of the European Union and Health
5.10.1. Commission’s Report on Enlargement and Health
5.10.2. Addressing Health and Enlargement at the Plenary Session of the European Parliament
5.10.3. Bowis Report: Parliament’s Report on the Consumer Protection and Health Aspect of Enlargement
5.10.4. European Union’s Health Strategy 2000, Health Action Program 2003-2008 and Enlargement
5.10.4.1. Health Information
5.10.4.2. Health Threats
5.10.4.3. Addressing Determinants of Health
5.10.5. Recommendations of the European Union Health Policy Forum on Health and Enlargement
5.11. European Union Budget and Health
5.12. European Union Research and Education Programmes and Health
5.12.1. Fourth Framework Research Program (FP4): 1994-1998
5.12.2. Fifth Framework Research Program (FP5): 1998-2002
5.12.3. Sixth Framework Research Program (FP6): 2002-2006
5.12.4. Seventh Framework Research Program (FP7): 2007-2013
5.12.5. Horizon 2020: European Research and Innovation Framework Program 2014-2020
5.12.5.1. Health, Demographic Change and Welfare
5.13. Education and Training in the European Union and Health Services
5.13.1. Leonardo Education Program
5.13.2. Socrates-Erasmus Programme
5.13.3. Erasmus Plus Programme
CHAPTER 6
EUROPEAN HEALTH SYSTEMS: COMPARISON AND ANALYSIS OF HEALTH SYSTEMS OF MEMBER AND CANDIDATE COUNTRIES OF THE EUROPEAN UNION
6.1. Introduction
6.2. Health Systems
6.2.1. Definition and Boundaries of the Health System
6.2.1.1. Internal Elements of the Health System
6.2.1.2. External Elements of the Health System
6.2.2. Goals of the Health System
6.2.2.1. Main Objectives
6.2.2.1.1. Health Promotion
6.2.2.1.2. Meeting Expectations
6.2.2.1.3. Fair Financin
6.2.2.2. Auxiliary Purposes
6.2.3. Functions of the Health System
6.2.3.1. Financing
6.2.3.1.1. Generating Income
6.2.3.1.2. Fund Raising
6.2.3.1.3. Purchasing
6.2.3.2. Delivery of Health Services
6.2.3.3. Providing Resources and Organizing
6.2.3.4. Management and Regulation
6.3. Comparative Health Systems
6.3.1. Reasons for Comparing Health Systems
6.3.2. Challenges of Comparing Health Systems
6.3.3. Approaches to Comparing Health Systems
6.3.3.1. Historical Approach
6.3.3.2. Partial Approach
6.3.3.3. Ideal Types
6.3.3.4. Modelling
6.3.4. Classification Studies of Country Health Systems
6.4. European Health Systems
6.4.1. Origins of European Health Systems
6.4.1.1. The First Period
6.4.1.2. The Second Period
6.4.1.3. The Third Period
6.4.1.4. The Fourth Term
6.4.2. Classification of Health Systems of European Union Member and Candidate Countries
6.4.2.1. National Health Service (NHS): The Beveridge Model
6.4.2.2. Social Insurance Model (SIM): The Bismarck Model
6.4.2.3. Semashko Health System Model
6.4.3. Comparison and Analysis of Health Systems of Member and Candidate Countries of the European Union
6.4.3.1. A Framework for Comparing and Examining European Union Country Health Systems
6.4.3.1.1. Comparison of Health Systems of European Union Member and Candidate Countries
6.4.3.1.2. Review of Country Health Systems
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