The Maastricht Treaty 1992: Taking stock of the past and looking at future perspectives

Abstract

Aim: The article contains a personal view of the history as well as the future of the European Union‟s (EU) health policy. Describing and evaluating the developments on the road from the Treaty of Maastricht to a new Europe it asks and tries to answer the question if weespecially the EU Member States – really know where we want to go to and how to get there. Method: Based on personal experiences, countless EU documents, as well as scientific publications the paper shows the impact EU Health policy has had in the Member States in the past. Historical development: Considering that the legal basis for health has been and remains to be very weak limiting EU action to support, coordinate, and supplement actions of Member States – which, as a rule, still consider health to be first and foremost a national responsibility and therefore do not want interference from international institutions – the amount and content of EU health activities in the past years has been quite remarkable. Health policy may not be an EU priority and as a crosscutting policy sector it is dominated by many other EUpolicies. However, especially the “hard law” regulations and directives of the Internal Market give EU the power and competence to achieve health objectives. The size of this growing influence is shown by direct interventions, made possible by the legal acts to improve economic policy coordination. Health and health care in this context are considered as a key policy area for economic growth and EU macroeconomic policy. On the other hand, there isrisk that such regulations affecting health policy and population health may be dominated too much by economic institutions and their interests, whereas health authorities play onlyminor role to date. Conclusion: For the future of EU health policy it is essential that its position is considerably strengthened, in order to assure that health interests of the EU population are sufficiently safeguarded.