In Scandinavia, the state is responsible for the regulation, financing, as well as the provision of health services. Thus, national health systems characterized by universal coverage are core elements of the Scandinavian welfare states. However, this health system model has been challenged by the EU – Denmark and Sweden through their membership in the European Union (EU); Norway through its participation in the Agreement on the European Economic Area (EEA). EU does not have strong competencies in health policy. In fact, the Lisbon’s Treaties’ Article 168, paragraph 7, clearly states that “Union action shall respect the responsibilities of the Member States for the definition of their health policy and for the organization and delivery of health services and medical care”. Still, EU influences national health systems in a number of areas. Much of this influence is related to the EU’s competence in the regulation of the Single European Market. EUs rules and principles concerning the free movement of goods, persons and services, as well as competition, have “spilled over” to the health area and affected national health models in ways that were not originally anticipated nor intended by the member countries. Thus, in Scandinavia, we see that the “EU market regulation model” has clashed against the “national welfare state model”.
This paper explores how this “clash” has taken place, which elements of health policy and regulation have been affected, and what the implication are of the “Europeanization of health policies” for the organization and further development of the Scandinavian health systems. The paper is primarilly to be based on a review of existing literature.
