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Member State Interests and European Union Law

The Case of Health Policy and Health Systems

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Between Compliance and Particularism

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Abstract

In matters of health policy, the Member States enjoy extensive retained competences and are prepared to act in the protection of their prerogatives and discretion. Their principal interest is to protect from EU intervention their ability to develop, operate and finance national health systems as dictated by domestic political, social and economic factors. As demonstrated by the example of cross-border health care, the Member States are acutely aware of the limitations which may follow from EU law—specifically, the fundamental freedoms—for the exercise of their health policy competences, which provides an incentive for them to legislate on the matter clarifying and consolidating the boundaries between EU obligations and Member State discretion. In contrast, EU membership has also given opportunities for the Member States to realise interests in the health policy domain which require a collective effort from the affected—interdependent—States. This led to the Member States conferring powers and functions to the Union and its institutions to develop cross-border policies and introduce cross-border obligations. In the wake of the financial and economic crisis, the Member States were also confronted with a new form of intervention by the Union—under the framework of common macroeconomic and fiscal governance—where, as dictated by the common interests, national health systems, health care budgets and health care reform are subject to external monitoring and rather substantive external constraints.

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Notes

  1. 1.

    As defined in Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare, [2011] OJ L88/46, the concept of “cross-border health care” means health care provided in a Member State other than the Member State of affiliation, where a patient is insured.

  2. 2.

    Council Regulation (EEC) No 1408/71 of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the community, [1971] OJ L149/2.

  3. 3.

    Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems, [2004] OJ L200/1.

  4. 4.

    See, for the final evaluation report of the campaign, European Commission (2015).

  5. 5.

    Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use, [2001] OJ L311/67.

  6. 6.

    Directive 2010/45/EU of the European Parliament and of the Council of 7 July 2010 on standards of quality and safety of human organs intended for transplantation, [2010] OJ L207/14.

  7. 7.

    Directive 2002/98/EC of the European Parliament and of the Council of 27 January 2003 setting standards of quality and safety for the collection, testing, processing, storage and distribution of human blood and blood components and amending Directive 2001/83/EC, [2002] OJ L33/30.

  8. 8.

    Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices, amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EEC, [2017] OJ L117/1.

  9. 9.

    Regulation (EU) 2017/746 of the European Parliament and of the Council of 5 April 2017 on in vitro diagnostic medical devices and repealing Directive 98/79/EC and Commission Decision 2010/227/EU, [2017] OJ L117/176.

  10. 10.

    Directive 98/43/EC of the European Parliament and of the Council of 6 July 1998 on the approximation of the laws, regulations and administrative provisions of the Member States relating to the advertising and sponsorship of tobacco products (no longer in force), [1998] OJ L213/9.

  11. 11.

    Directive 2003/33/EC of the European Parliament and of the Council of 26 May 2003 on the approximation of the laws, regulations and administrative provisions of the Member States relating to the advertising and sponsorship of tobacco products, [2003] OJ L152/16.

  12. 12.

    Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC, [2014] OJ L127/1.

  13. 13.

    Judgment of 4 May 2016, Poland v Parliament and Council (Tobacco Products), C-358/14, EU:C:2016:323.

  14. 14.

    Inter alia, Judgment of 5 October 2000, Germany v Parliament and Council (Tobacco Advertising), C-376/98, EU:C:2000:544; Judgment of 12 December 2006, Germany v Parliament and Council, C-380/03, EU:C:2006:772; Judgment of 4 May 2016, Poland v Parliament and Council (Tobacco Products), C-358/14, EU:C:2016:323.

  15. 15.

    Judgment of 4 May 2016, Poland v Parliament and Council (Tobacco Products), C-358/14, EU:C:2016:323.

  16. 16.

    See, in this respect, Cornelissen (1996).

  17. 17.

    Judgment of 28 April 1998, Decker, C-120/95, EU:C:1998:167; Judgment of 28 April 1998, Kohll, C-158/96, EU:C:1998:171; Judgment of 12 July 2001, Geraets-Smits and Peerbooms, C-157/99, EU:C:2001:404; Judgment of 13 May 2003, Muller-Faure, C-385/99, EU:C:2003:270; Judgment of 16 May 2006, Yvonne Watts, C-372/04, EU:C:2006:325; Judgment of 19 April 2007, Stamatelaki, C-444/05, EU:C:2007:231; Judgment of 9 October 2014, Petru, C-268/13, EU:C:2014:2271.

  18. 18.

    Judgment of 13 May 2003, Muller-Faure, C-385/99, EU:C:2003:270.

  19. 19.

    Judgment of 12 July 2001, Geraets-Smits and Peerbooms, C-157/99, EU:C:2001:404.

  20. 20.

    Judgment of 16 May 2006, Yvonne Watts, C-372/04, EU:C:2006:325.

  21. 21.

    See, for a detailed analysis of such infringement procedures, Gekiere et al. (2010).

  22. 22.

    Regulation (EU) 472/2013 of the European Parliament and of the Council of 21 May 2013 on the strengthening of economic and budgetary surveillance of Member States in the euro area experiencing or threatened with serious difficulties with respect to their financial stability, [2013] OJ L140/1.

  23. 23.

    Regulation (EU) 473/2013 of the European Parliament and of the Council of 21 May 2013 on common provisions for monitoring and assessing draft budgetary plans and ensuring the correction of excessive deficit of the Member States in the euro area, [2013] OJ L140/11.

  24. 24.

    See, for an analysis of these health reform “prescriptions”, Földes (2016).

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Authors and Affiliations

  1. The Hague University of Applied Sciences, The Hague, The Netherlands

    Mária Éva Földes

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  1. Center for Social Sciences, Hungarian Academy of Sciences, Budapest, Hungary

    Marton Varju

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Földes, M.É. (2019). Member State Interests and European Union Law. In: Varju, M. (eds) Between Compliance and Particularism. Springer, Cham. https://doi.org/10.1007/978-3-030-05782-4_10

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