Solidarity as a Political Determinant of Health: Insights from EU Competition Policy.

Abstract

The connection between law and political determinants of health is not well-understood, but nevertheless it is suggested that the two are inseparable, and that this represents an "upstream" level with scope for influencing other determinants of health (particularly social). Solidarity underpins European healthcare systems and given its clear link with redistribution, can be seen as a means to address health inequities. As such, solidarity may be seen as a political determinant of health in the specific context of EU competition policy. A range of EU case law, Treaty provisions, and Commission publications relating to EU competition policy are analysed. Solidarity is typically juxtaposed as antithetical to competition, thus underpins exceptions to the applicability of the prohibitions on anticompetitive agreements, abuse of dominance, and state aid. Case law indicates a further dynamic between definitions of solidarity at EU and national levels. This analysis leads to two groups of considerations when framing solidarity as a political determinant of health in the EU competition policy context: firstly, the predominance of solidarity suggests it may shape competition reforms, and secondly the EU-Member State dynamic which indicates less EU-level reach into national competition reforms in healthcare than may be expected.