Case 4: Covid-19 & European health union Flashcards
Why have a European Health Union?
- Expanding Unions preparedness & resonse capacities to make health systems more resilient
- Potential to strengthen crisis preparedness & management of cross-border health threats by reinforcing & empowering the EMA and ECDC
What is the responsibility of the European Commission?
responsibility to shape PH agenda & oversee implementation of EU legislation → but they don’t function in a vacuum
What do we mean when we say the European Commission doesn’t function in a vacuum?
- Governmental actors, lobby groups & other stakeholders are also involved
- Not always transparent who gets a voice when it comes to shaping
public policy → in PH, MS retain control over health policy & functioning of their health systems = more complicated - Results in divergent perspectives & approaches that open floor to national & international interest groups → the roles that lobby/interest groups play in influencing agenda setting must be understood extensively
What is a typical way to create a policy window?
Crisis response is a typical way to create a policy window that can enable a reframing of issues to influence the agenda
Why is it difficult to have a European Health Union?
- Due to the high amount of actors with different interest groups
- etc
What is agenda setting?
- collection of problems; understanding of causes, symbols, solutions of problems that come to attention of public & governmental officials
- agendas exist at all levels of government
What does agenda setting focus on?
raising issues for discussion and looks at the competition among issues
What is a systematic agenda?
all issues commonly perceived as requiring public attention
What is an institutional agenda?
list of items that need active consideration from legitimate decision-makers with some level of authority
Explain agenda setting and how they move issues
A process by which groups compete to move their issues from a systematic agenda to a institutional agenda
What is the process of agenda setting?
Problem recognition is a socially constructed process & not very rational → policy actors tend to clash during problem recognition
How is discourse influenced?
Discourse (way we think and talk about things) is influenced by context and shapes how a problem is perceived → policy tourists come and go
What is framing?
Process of selecting & presenting types of information that shape how people understand & interpret an issue → often there are competing frames
What is a venue?
Institutional forums in which decisions are taken on policies → legislative, executive, judicial or the news media (Ministry of Health)
Why are some issues not put onto the agenda?
- Issue isn’t relevant, prioritised or a legitimate government concern
- Non-decision making (governments actively decide not to act)
- Issue is purposely kept off the agenda
According to Kingdon’s mutliple streams framework, when do issues appear on the agenda?
- Issue is recognised & a problem
- Accumulate knowledge & different perspectives in policy area
- Political events
Explain “issue is recognised & is a problem” as part of Kingdons claims as to when issues appear on the agenda
The issue is recognised and a problem - develops the frame of understanding
Explain ” accumulate knowledge and different perspectives in the policy area” as part of Kingdons claims as to when issues appear on the agenda
finding alternative solutions & generating different policy proposals
Explain “political events” as part of Kingdons claims as to when issues appear on the agenda
political processes like:
* national mood
* legislative turnover
* interest group involvement
* public opinion
* election results
* state of economy
* technology
What is a policy stream?
Problems, solutions & political events all together can motivate/constrain change that can enable an issue to be placed on the agenda.
What 2 broad phenomena is agenda setting driven by according to Kingdon?
- Changes in indicators of underlying problems
- Focusing events
Explain the phenomena by Kingdon “changes in indicators of underlying problems” as a driver of agenda setting
lead to debates on the extent of the problem (through data collection, monitoring, analysis)
Explain the phenomena “focusing events”
- sudden shocks to policy systems that lead to attention & agenda change & eventually a policy change
- (e.g. 9/11 and war on terror)
- Focusing event by itself is often insufficient to drive change
Who can set the agenda?
Individual & group actors involved:
* political administrative officials
* legislators
* academics
* development partners such a donors
* NGOs
* media
* institutions such as unions
* consumer groups
* patient groups
* companies
* the public
How are policy outcomes infleunced?
- Engage in framing problems & understand how agendas are set
- Recognise political windows of opportunity
- understand how to manipulate political processes to encourage wider acceptance of problem definition
- Understand positions, interests & power of other interested parties (& media)
- Adapt solutions to make them more politically legitimate, feasible &
supported by the public → need for flexibility
What 3 components exists of the European healthcare union?
- European refers to EU
- Healthcare
- Union
Explain healthcare as a component of European healthcare union
Healthcare being the organisation, financing & provision of diagnosis, care & cures to ill people, including pharmaceuticals & medical devices → should be distinguished from public health which is broader & includes all policy measures to increase well-being of all people
Explain union as a component of European healthcare union
Union refers to a commonality that makes a collection of units (e.g. health systems) a distinct entity → may involve common use of professionals, patients or other healthcare system actors, common financing or regulation → strength varies
What are the drivers of EHU?
What is a top-dwn vs bottom-up approach?
- top-down approach goes from the general to the specific
- bottom-up approach begins at the specific and moves to the general
*What are the stages of implementation experienced?
p.30 of stuvia
- Mobilisation (bottom-up)
- Gaining access (exchanging experiences)
- Use of implementation experiences
Explain mobilisation (bottom-up) with regards to EU implementation & policy change
how and by whom is implementation mobilised and what are motivations to do so
Explain gaining access (exchanging experiences) with regards to EU implementation & policy change
process of gaining/creating access to policymakers → important to analyse venus most receptive to this type of expertise → depends on demand for information
Explain use of implementation experiences with regards to EU implementation & policy change
other factors which affect if these experiences are actually used → legitimacy, political factors, conflict, societal interests, technical knowledge, etc
What is the importance of European dimension in health?
● Viruses/bugs are not confined within borders, and neither are European citizens due to the freedom of movement
● Services, including digital services, are offered across borders
● Increased globalisation of trade & interconnected supply chains
● Climate change is a European and global problem
● Principle of solidarity across the continent and moral obligations
What are some EU health policies as a shared competence?
- Principle of conferral (Art 5 (2) TEU): EU can only act within PH as stated in the treaties. Appplies to art 4,6,168 in TFEU
- Principle of subsidiartiy (Art 5 (3) TEU): EU only permitted to act if there’s added value relative to MS action
- Principle of proportionality (art 5 (4) TEU): union action shall not exceed what is necessary
