Quo Vadis Europe? Maybe in the Wrong Direction THE FUTURE OF EUROPEAN HEALTH POLICIES

The role of the European Union in health policies is changing. The European social model is under threat due to shifts in E.U. policies on liberalization of service provision, limited public budgets, a focus on the health sector as a productive sector in the context of broader European policies and the Lisbon strategy, and changes in the context of the new Constitutional Treaty. These changes are evident in a new reflection paper on European health strategy and its focus. E.U. health policies are at a critical juncture. The danger is that the current processes will lead European health policies and the health systems of member states more in the direction of U.S. health policies and the commercialization of health systems than toward improve-ment of the current situation. The organization and financing of health services varies among E.U. member-states, but a common feature of European health care systems has been their commitment to universal coverage and solidarity in financing—the “European approach ” or the “European social model. ” There is clear evidence that, in the field of health care, the European model continues to have more wide-spread citizen support in Europe than does its American alternative in the United States. As Mossialos and McKee (1) have pointed out, public opinion surveys in Europe and the United States have shown consistently higher satisfaction with health services in Europe. These systems have also survived intact in the face of changing economic fortunes, and where fundamental changes have been attempted, they have failed or have been rejected by a public that places a high value on the underlying concept of social solidarity. There is thus evidence that not only has a set of shared values given rise to the welfare state in all E.U. member-states, but these values are distinct from those in th