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The European Union and Health Services – The impact of the Single European Market on Member States

Busse R, Wismar M, Berman P (eds.)

Amsterdam: IOS Press




The European Union and health services do not seem to sit easily together. While most Member State Governments have assumed that they have full responsibility and control over their own health services, on the basis of Article 152 of the Amsterdam Treaty, it is becoming increasingly apparent that the Single European Market is having a substantial impact on health services. Recent rulings by the European Court of Justice (ECJ) have, in particular, established the freedom of citizens to choose health care goods and services across borders.

To examine the actual relationship between the SEM and health services, this book

- identifies SEM regulations and directives as well as ECJ decisions which explicitly refer to health services and which therefore have a potential impact on the purchasing, supply and delivery of health services,

- evaluates the impact of SEM regulations and ECJ decisions on the purchasing, supply and delivery of health services,

- identifies outcomes, including both intended and unintended effects, of the SEM on Member States’ health services and

- develops futures scenarios exploring key issues identified in the earlier analysis and evaluation.


Table of Contents

Edited on behalf of the European Health Management Association ( EHMA ) by Reinhard Busse ( European Observatory on Health Care Systems ), Matthias Wismar ( Hannover Medical School, Germany ) and Philip Berman ( EHMA ), the book includes contributions by Pauline Ong and CalumPaton ( Keele University, UK ), Clas Rehnberg ( Stockholm School of Economics, Sweden ), Barbro Renck and Mona Sundh ( Karlstad University, Sweden ), Nuria Romo and Fernando Silio ( Andalusian School of Public Health, Granada, Spain ).



  • The European Union and health services: Summary
  • Part I: Introduction
  • The European Union and health services - the context

    The Single European Market and health services - the research design

  • Part II: Single European Market legislation and jurisdiction
  • Analysis of SEM legislation and jurisdiction

    Transposition of European directives into national legislation

    Part III: Free movement of persons

    The mobility of doctors and nurses – a United Kingdom case study

    Scenarios on the future mobility of doctors and nurses

    The mobility of citizens – a case study and scenario on the health services of the Costa del Sol

    The impact of the SEM on data exchange and protection in the Swedish health system

    Part IV: Free movement of goods and services

    A Swedish case study on the impact of the SEM on the pharmaceutical market

    The impact of the SEM on the medical devices market in Sweden

    The SEM and the public procurement of goods and services in the Andalusian Health Service

  • Consumer choice of medical goods across borders
  • Consumer choice of healthcare services across borders
  • Scenarios on the development of consumer choice for healthcare services
  • Part V: The future
  • Scenarios on the future of healthcare in Europe

    Zusatzinformationen / Extras


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