It is a great pleasure to introduce this volume edited by Elias
Mossialos, Govin Permanand, Rita Baeten and Tamara Hervey. It
is a volume which continues the success of two earlier books commissioned
by the Belgian government and published by Peter Lang
Publishing Group in 2002.1 The topic of this contribution is a crucial
one. Indeed, one can hardly imagine a subject closer to the lives of
European Union (EU) citizens than an exploration of how EU law
and policy has influenced, and will continue to influence, the health
systems of the 27 Member States. This two-dimensional perspective
means that this work will certainly be studied with great interest by
all concerned with the functioning of the EU as well as by those wanting
to discover more about national health systems.
In principle, in light of Article 152 of the EC Treaty, national authorities
are solely responsible for health care. Yet, though the Member
States are free to decide how to deliver and organize health services,
they must do so in compliance with other aspects of the Treaty, in
particular with the fundamental freedoms and elements of competition
law. Put differently, national health systems are not enclaves
of national sovereignty insulated from European market integration.
While EU legislators may not regulate health care as a means of promoting
social cohesion, they may, however, enact legislation relating
to those aspects affecting the establishment and functioning of the
internal market. Given that national health systems are deeply rooted
in social solidarity and welfare, the “constitutional asymmetry” (to
borrow the term used by Fritz Scharpf) laid down in the Treaty gives
rise to important tensions.