Choosing Paths in European Union Health Policy: A Political Analysis of a Critical Juncture

Abstract

Health policy in the European Union is at a critical juncture: a moment in which decisions are highly contingent but, once taken, will shape politics and policy for the future. EU health policy is contingent because of its sideways development; it has emerged as an issue due to the decisions of the European Court of Justice rather than member state volition. There is, accordingly, no established EU health policy community or trajectory. Instead, there are a range of different models of health policy, each with different logics, lineages, policy tools and bureaucratic sponsors. But the decisions taken in this fluid situation will shape future policy because of the importance and “stickiness” of the EU- once the European Court of Justice has taken a decision, or legislation has passed, it is difficult to undo it. This article explains the nature of the external shock that created an EU policy arena where none had been; the reasons that decisions taken now will be subject to the logic of path dependency; and the different models that are being put forward for the EU.