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EU Country Specific Recommendations for health systems in the European Semester process: Trends, discourse and predictors

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  • Azzopardi-Muscat, Natasha
  • Clemens, Timo
  • Stoner, Deborah
  • Brand, Helmut

Abstract

In the framework of “Europe 2020”, European Union Member States are subject to a new system of economic monitoring and governance known as the European Semester. This paper seeks to analyse the way in which national health systems are being influenced by EU institutions through the European Semester. A content analysis of the Country Specific Recommendations (CSRs) for the years 2011, 2012, 2013 and 2014 was carried out. This confirmed an increasing trend for health systems to feature in CSRs which tend to be framed in the discourse on sustainability of public finances rather than that of social inclusion with a predominant focus on the policy objective of sustainability. The likelihood of obtaining a health CSRs was tested against a series of financial health system performance indicators and general government finance indicators. The odds ratio of obtaining a health CSR increased slightly with the increase in level of general Government debt, with an OR 1.02 (CI: 1.01, 1.03; p=0.007) and decreased with an increased public health expenditure/total health expenditure ratio, with an OR 0.89 (CI: 0.84, 0.96; p=0.001). The European Semester process is a relatively new process that is influencing health systems in the European Union. The effect of this process on health systems merits further attention. Health stakeholders should seek to engage more closely with this process which if steered appropriately could also present opportunities for health system reform.

Suggested Citation

  • Azzopardi-Muscat, Natasha & Clemens, Timo & Stoner, Deborah & Brand, Helmut, 2015. "EU Country Specific Recommendations for health systems in the European Semester process: Trends, discourse and predictors," Health Policy, Elsevier, vol. 119(3), pages 375-383.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:3:p:375-383
    DOI: 10.1016/j.healthpol.2015.01.007
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    References listed on IDEAS

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    1. Clemens, Timo & Michelsen, Kai & Brand, Helmut, 2014. "Supporting health systems in Europe: added value of EU actions?," Health Economics, Policy and Law, Cambridge University Press, vol. 9(1), pages 49-69, January.
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    Cited by:

    1. Mattia Guidi & Igor Guardiancich, 2018. "Intergovernmental or supranational integration? A quantitative analysis of pension recommendations in the European Semester," European Union Politics, , vol. 19(4), pages 684-706, December.
    2. Sara Casagrande & Bruno Dallago, 2022. "Socio-Economic and Political Challenges of EU Member Countries: Grasping the Policy Direction of the European Semester," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 64(3), pages 487-519, September.
    3. Heinonen, Noora & Koivusalo, Meri & Keskimäki, Ilmo & Tynkkynen, Liina-Kaisa, 2024. "Is the EU steering national social and health policy making? A case-study on Finland's national reform," Health Policy, Elsevier, vol. 145(C).
    4. Camilleri, Carl & Jofre-Bonet, Mireia & Serra-Sastre, Victoria, 2018. "The suitability of a DRG casemix system in the Maltese hospital setting," Health Policy, Elsevier, vol. 122(11), pages 1183-1189.
    5. Azzopardi-Muscat, Natasha & Baeten, Rita & Clemens, Timo & Habicht, Triin & Keskimäki, Ilmo & Kowalska-Bobko, Iwona & Sagan, Anna & van Ginneken, Ewout, 2018. "The role of the 2011 patients' rights in cross-border health care directive in shaping seven national health systems: Looking beyond patient mobility," Health Policy, Elsevier, vol. 122(3), pages 279-283.
    6. Reinout A van der Veer & Markus Haverland, 2018. "Bread and butter or bread and circuses? Politicisation and the European Commission in the European Semester," European Union Politics, , vol. 19(3), pages 524-545, September.
    7. Frischhut, Markus & Levaggi, Rosella, 2015. "Patient mobility in the context of austerity and an enlarged EU: The European Court of Justice's ruling in the Petru Case," Health Policy, Elsevier, vol. 119(10), pages 1293-1297.
    8. Sabina Stan & Roland Erne, 2021. "Time for a paradigm change? Incorporating transnational processes into the analysis of the emerging European health-care system," Transfer: European Review of Labour and Research, , vol. 27(3), pages 289-302, August.

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