The Changing World of European Health Lobbies

Health seems like an unlikely candidate for Europeanization. It is at the core of the welfare state, vitally important to member states and their politicians, and consequently long protected from European Union (EU) policy. EU treaties have only weak and tightly delimited health policy competencies, reflecting member states’ unwillingness to countenance EU (or any outside) intervention in health. The interest group ecology is also tightly bound to states, no matter how international the conference circuit. Even in countries with little or no corporatism, such as the United Kingdom, there is a great deal of ‘private interest government’ in health (Streeck and Schmitter 1985; Salter 2004). In such tightly drawn policy sectors, Europeanization of interests and policymaking might be a dramatic shock for policy-makers, and a dramatic case study of theories of European politics and integration for the scholars. The development of EU health policy is giving scholars just that case study. A fledgling European health policy arena is developing as a result of exogenous shocks to existing systems administered by the Court and Commission. I argue that investment by interest groups and policy advocates in EU health lobbying is in response to either the explicit efforts of the Commission to win allies for new policy ventures (so far mostly in public health) or a defensive reaction to the increasingly complex and important EU judicial and legislative agenda in health services, consistent with the findings of Wessels that groups become engaged when they realize the EU is potentially engaged with their issue (Wessels 2004). Groups that would be interested in liberalization ‐ seemingly just what the EU health services agenda provides ‐ are focusing not on helping the liberalizers at the EU level but on developing connections in member states. The result is NGO and professional dominance that stands in contrast to the usual EU pattern in which business dominates lobbying. It also poses the