title: Unhealthy European health policy.
abstract: The European Union claims that the defense of its welfare state is one of today's most important challenges. This article analyzes whether the European governments and the European Union really pursue a policy that strengthens their health and social security systems, or one that is in itself a threat to health and social security. After a summary of the origin and evolution of the European health systems, the authors pinpoint underlying reasons for reform and demonstrate how, since the 1990s, the European Union has built a strict financial and political straitjacket, forcing these systems to carry out privatization and cutbacks. Reform measures can be divided into three interdependent categories: (1) the increasing influence of governments on health care organization, to enable restructuring; (2) measures aimed at reducing public expenses, including higher financial contributions by patients and restrictions on the range of services provided; and (3) measures that establish competition and hidden or open privatization of services and insurance systems. Through these mechanisms public expenses are reduced while private health care expenses (and private profits) rise freely. Ongoing European health care reforms thus struggle with the contradictions between responding to growing collective needs and securing or increasing private profits.
authors.affiliation: Department of Public Health, Institute for Tropical Medicine, Antwerp, Belgium. pdevos@itg.be
authors.forename: Pol
authors.initials: P
authors.lastname: De Vos
authors.forename: Harrie
authors.initials: H
authors.lastname: Dewitte
authors.forename: Patrick
authors.initials: P
authors.lastname: Van der Stuyft
mesh_terms: D003695:Delivery of Health Care / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D004465:Economic Competition; D017598:Efficiency, Organizational; D005062:European Union; D018166:Health Care Reform; D005102:Health Expenditures / Q000706:statistics & numerical data; D006291:Health Policy; D006801:Humans; D017146:Models, Organizational; D011050:Policy Making; D011332:Privatization; D012943:Social Security; D012946:Social Welfare