A judicialisation of healthcare policies in Denmark and Spain? The universalist healthcare model meets the European Union

Abstract

This article examines the impact of judicialisation on the right to cross-border healthcare in Denmark and Spain, that is, the national impact of legal integration as spurred by the Court of Justice of the European Union. We expect the national impact of judicialisation to be conditioned by the ex-post judicial, administrative and political responses, particularly the national courts’ activation of EU law. By using new data, a compilation of national court cases, quasi-judicial proceedings and research interviews with key respondents, we examine the process of judicialisation in the two member states. The findings demonstrate that the national courts hardly played a role in Denmark and that although the courts were more active in Spain, the rulings remained largely unobserved by the political and administrative elite and the courts were thus unable to push for change. The administrative and political responses were found to be quite similar in the two member states, adapting to EU-induced changes in a protectionist and defensive manner. We conclude that the two universalistic healthcare models have so far proved resistant to judicialisation and that the discrepancy between what emerges de jure at the supranational level and the de facto rights produced at the national level is still a wide one.