Cross Border Health Care: An Analysis of Recent ECJ Rulings

Recent rulings of the European Court of Justice show a trend towards a virtual European health-care basket. Four developments underlie this trend. First, the competence of the European Union seems to mature in the field of health care. Secondly, through a variety of authorisation procedures, individual Member States can to a large extent determine the conditions for cross border care. Thirdly, recent court cases indicate that the co-ordination of cross border care increasingly becomes a EU matter. Finally, in particular border regions, more flexible procedures for cross border care are being developed. An analysis of these developments from an (economic) institutional/constitutional point of view shows that potential Pareto-improvements can be expected from recent changes. These improvements depend on the institutional/constitutional framework into which these rules and engagements are embedded. Our analysis suggests that, although the current (increasing) role for the EU seems desirable, diminishing the role that individual Member States can play is not. National authorisation procedures, local/regional arrangements and flexible rulings are mechanisms that can secure an efficient level of output and an optimal size of the jurisdiction responsible for cross border care. This leads to the following recommendations: Current authorisation procedures (which differ per Member State) have to be maintained in order to secure an optimal community size for cross border services and goods; Bilateral agreements and flexible procedures in cross border regions should be stimulated in order to adapt institutional arrangements to the demand for cross border care by (a group of) individuals. The increased competency of the EU in the field of health care can best be used to make authorisation procedures more consistent and stimulate regional cross border care arrangements.     

Mapping legislative socialisation

Abstract Legislative socialisation has long been an important force for political deradicalisation in capitalist democracies worldwide. It remains barely explored, however, in large part because it is a process very difficult to track by conventional observational or survey methods. We circumvent these problems by taking advantage of an unusually propitious vote on televising the proceedings of the British House of Commons to chart the institutional deradicalisation of its Labour members. Socialisation effects are shown to be non–linear and, while the difference is not statistically significant, to be marginally stronger among Members of Parliament (MPs) with frontbench experience. The somewhat greater conservatism of frontbenchers, however, cannot be explained by anticipatory socialisation. Rather, it seems to be a function of doing well under 'rules of the parliamentary game' threatened by proposals for institutional reform.     

Mapping legislative socialisation

Legislative socialisation has long been an important force for political deradicalisation in capitalist democracies worldwide. It remains barely explored, however, in large part because it is a process very difficult to track by conventional observational or survey methods. We circumvent these problems by taking advantage of an unusually propitious vote on televising the proceedings of the British House of Commons to chart the institutional deradicalisation of its Labour members. Socialisation effects are shown to be non–linear and, while the difference is not statistically significant, to be marginally stronger among Members of Parliament (MPs) with frontbench experience. The somewhat greater conservatism of frontbenchers, however, cannot be explained by anticipatory socialisation. Rather, it seems to be a function of doing well under 'rules of the parliamentary game' threatened by proposals for institutional reform.     

National health policy: Efficiency-equity synchretism

A new emphasis in national health policy to encourage efficiency has been born in an environment of slower economic growth and an aging population. The increased reliance on market incentives to reduce health care costs does not signal the abandonment of equity as a social objective. To the contrary, the new emphasis on efficiency is intended to provide more and better health care through the generation of savings from the use of management systems to improve productivity. Market incentives and new management systems to increase efficiency are not the antithesis of equity but tools to provide better health care to the poor and to the elderly in an environment of fiscal constraints.     

Scoring women on their labor changes

Women have less opportunities in the labour market than have men. Theories and material on inequality between the sexes are available, but it is not possible to determine accurately the precise handicap that women experience: an adequate means of measurement is lacking.In this article, the theoretical basis for the new complex variable LCS (Labour Chances Score) is described. LCS is developed to enable the measurement of the labour chances of arbitrary groups on the labour market, and to compare them. The LCS method has made the available qualitative data quantifiable. Scores are measured on the four elements of LCS: (being subject to) regulations; (being subject to) expectations; (unfolding) qualifications; (participation in) communication.The LCS mothod is to be used for policy research, as well in the emancipation of working women. Once a low score on a LCS-element is found, policy can be made to remove it.