For our weekly “Ideas on Europe” editorial by UACES, the University Association for European Studies, we welcome Mechtild Roos again, from the University of Augsburg, in Germany.
I hope you are well, although we have entered the yearly high infection season…
Yes, thank you for enquiring on my health! Which is anyway what you want to discuss today, since your current research focuses on health issues, although not in a personal, but the European context.
That’s true. Even though health might actually be one of the most personal things that politics and law can actually influence. One idea to do so has gained traction in EU politics particularly since the outbreak of the Covid-19 pandemic : namely, the idea of a European Health Union.
The current Commission is eager to establish such a Health Union. More specifically, it wants to – and I quote – ‘better protect the health of our citizens’, ‘equip the EU and its Member States to better prevent and address future pandemics’, and ‘improve [the] resilience of Europe’s health systems’. What exactly a European Health Union would entail, however, is still a bit vague, because different European institutions and countries have different ideas and interests in this matter.
Based on your research on different national and EU health policies: what do you think should be at the heart of a European Health Union ?
Let me put it like this: We may not (yet) live in a European Health Union. But we certainly do live in a European Health Risk Union in which risks both to public and individual health have come to enjoy a freedom of movement that is aligned to the freedom of movement of persons, goods, services and capital. If we want to be able to face such collectivised risk, we need more than a European Health Economy Union.
And that would mean concretely…?
The abolition of borders and the introduction of harmonised standards in the areas of production, research and development, services and workforce in the healthcare sector. While this is an important part of a Health Union, it is not enough. It is also not enough to set EU-level legal standards in the area which the member states are then left to implement individually.
Why not ?
Because, understandably, the main target group of national-level politics and politicians are their own citizens. However, when it comes to public health, we as a society are naturally only as strong as our weakest members. Thus, collective risk and resilience are determined by all members of society – based not on the name of a country in our passports, but on residence, be it short- or long-term residence.
A European Health Union which leaves policy interpretation to the member states effectively means that policymakers who (understandably) focus on their fellow nationals, for reasons of re-election or other, will likely put second anyone with another (or no) citizenship, be they EU or non-EU nationals. This also means that national-level implementation of EU-level health standards becomes prone to political instrumentalization in different actors’ pursuit of a wide variety of political objectives.
As a result, health rights of societal ‘outsiders’, such as migrants and refugees, are often restricted. This deepens divides between ‘insiders’ and ‘outsiders’ and increases not only these ‘outsiders’’ vulnerability but weakens our collective resilience.
So how does that fit your concept of a European Health Union ?
Well, in order to minimise the risks that we collectively face, I would argue that we need a European Health Rights Union. This means: a union which grants and guarantees to all its residents the same high-level rights and access to health and healthcare. In other words: we need not only the EU-level law, but also EU-level insurance of its implementation. ‘The highest attainable standard of health’ has been declared a human right as early as 1946 and is to some extent also enshrined in Art. 35 of the EU Charter of Fundamental Rights, which – by the way – is legally binding! Yet, national health systems, legislation and policy implementation effectively restrict the formal health rights of millions across Europe. Many of them belong to particularly vulnerable social groups. From a public health perspective, every such vulnerability creates (unnecessary) access points for health impairment.
Of course, I’m not naïve. Access to healthcare of these groups is restricted by historically grown health systems and legislation – both of which take a lot of effort and time to change. And I am also aware that in our current times of political, economic and social ‘polycrisis’, demographic change, and already strained healthcare systems and national budgets, guaranteeing high-level health rights for all may sound like a utopia.
But considering the immense impact of both individual and public health on every aspect of our lives, our societies and our economies, I dare say it is a utopia worth pursuing. And the EU, as a supranational governance system, despite its (yet) limited competences in the areas of health and healthcare, is in a unique position to do so.
Many thanks for sharing your “Idea on Europe” with us. I assure you that euradio remains open for utopias!
Next week we will welcome Natasza Styczynska from the Jagiellonian University in Cracow.
Interview by Laurence aubron.