The paper argues that the governance of transnational patient mobility in Europe has to be approached from an encompassing perspective that includes other types of healthcare mobilities and of healthcare governance in the European Union.
Starting from this perspective the paper argues that, while healthcare services have traditionally been seen as being relatively insulated from the process of European integration, we are already witnessing their re-configuration in a rising European healthcare system. The paper therefore uncovers the structuring lines of this system by concentrating on three interrelated processes that contribute to linking European healthcare systems into a larger EU-level one:
1) ‘horizontal’ healthcare governance through the diffusion of healthcare privatisation reforms across the EU;
2) intra-European mobility of patients and healthcare workers;
3) ‘vertical’ healthcare governance through EU directives, ECJ rulings and bilateral investment agreements.
The paper argues that, while transnational patient mobility provides, together with healthcare worker mobility, the human glue to the rising European healthcare system, the process of healthcare privatisation provides its dynamo. Indeed, as privatisation leads to segmented labour markets and inequalities of access to services, it thus also fuels the mobility of healthcare workers and patients. These mobilities in turn feed into the use of and employment in private healthcare services. The resulting vicious cycle of privatisation helps construct an increasingly uneven European healthcare system, in terms of the distribution of access to services by patients, of wages and working conditions of healthcare workers, as well as of financial control and policymaking both among and inside EU countries.