For our weekly “Ideas on Europe” editorial by UACES, the University Association for European Studies, we welcome Dr Mechthild Roos again, from the University of Augsburg, in Germany.
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I have been told that you want to commemorate an anniversary with us …
Indeed! Almost exactly three years ago, on 11 November 2020, the European Commission under President Ursula von der Leyen took the first steps towards building a European Health Union.
To be honest, I don’t really remember the occasion. But I do remember of course the context of the COVID-19 pandemic.
A context of crisis. Yet, this Health Union was meant to be more than a mere reactive instrument of crisis management. It constituted an attempt at making health policy a genuine EU competence.
To be sure, the EU was not entirely powerless when COVID broke out. But still, health policy remains – until today – a policy area of fragmented EU competences, an area in which member states are keen to safeguard their national say. After all, each EU member state has a rather unique healthcare system. And governments are always reluctant to transfer competences to the EU level in policy fields that make for good election campaign material.
But why, then, did the Commission propose such an impressively-sounding initiative as a European Health Union?
Well, the EU, and most notably the Commission, is quite good at establishing grandiose names for (bundles of) initiatives that have a grand purpose, but a rather weak treaty basis. Other examples are the “European Pillar of Social Rights” or the “European Green Deal”. The EU has, of course, been active in all three fields – social policy, sustainability and environmental policy, and health policy – for decades. But none of these can claim a united political approach, let alone a comprehensive set of EU-level rules and norms that would be consistently implemented and applied in all corners of the Union. I rather have the impression that when the Commission feels the need to attribute a grand name to an area of action, it is very likely to be a field not only of high contemporary relevance, but of particularly vivid controversy among the member states. By assigning a grand name, the Commission seeks to construct a unity that does not yet exist.
That sounds as if you have little faith in the realisation of a European Health Union…?
For the time being, the Health Union is widely perceived as a bone of contention, a set of ideas, of piecemeal acts, and of many unadopted or unimplemented proposals, instead of a comprehensive pillar of EU law or policy.
Still, all hope is not lost. Every major crisis begs for constructive and durable solutions. And this may always leave actors in politics, civil society and the economy disappointed by the current state of realisation of the ‘grand initiatives’.
But even if they may stay below the expectations that were raised, it is worth acknowledging one major success that all of them have already achieved: they may not yet have resulted in tangible results, but they have made their respective field of action a field of EU intervention.
This may sound trivial. But it is not. One crucial function of grand names is to fill gaps in competences provided by the treaties. That is the main objective of the ‘European Health Union’: to push for the discursive construction of EU competences where there were few or none before, but where they are urgently required by new circumstances.
So what’s your guess: will we ever have a Health Union with real EU health competences?
Partial progress in this direction has already been achieved, as a growing number of submitted and now gradually adopted initiatives demonstrates. But to go further, another step needs to follow: the Commission, and the EU as a whole, needs to move on from a grand name on shaky feet, towards a stable and routinely growing construct of EU legislation.
To be followed, for sure. And we trust you’ll keep us up to date. Many thanks, Mechthild, for this picture of a policy in the making. I recall you are researcher at the University of Augsburg, in Germany.
Entretien réalisé par Laurence Aubron.