Uninvited Europeanization: neofunctionalism and the EU in health policy

Abstract Neofunctionalism lives on in health policy: while there are many ways in which the theory of Haas has become obsolescent, it still provides a convincing explanation of the expansion of EU competencies, as shown above all by the ongoing, unintended, development of a European health policy. Member states have carefully isolated health services and policy from the EU since its inception, granting only narrow responsibilities and weak tools relevant to marginal areas of policy. Yet today the EU is emerging as one of the formative influences in health policy. Simply put, the activities of EU institutions in areas outside health, both legislative and judicial, have had unexpected consequences for health by changing the legal environment under which health systems contract employees, purchase goods, finance services, and organize themselves. The result is systematic encroachments on health policy by the EU, driven by the Court and justified by internal market rules and decisions.