Choosing paths in European Union health services policy: a political analysis of a critical juncture

Health services policy in the European Union is at a critical juncture: a moment at which decisions are highly contingent but, once taken, will shape politics and policy for the future. There is no established EU health services policy community or trajectory because EU health services politics have been a reaction to decisions by the European Court of Justice. Instead, there are a range of different models of health policy, each with different logics, lineages, policy tools and bureaucratic sponsors. The decisions taken in this fluid situation will shape future policy because of the importance and `stickiness' of the EU. Once the European Court of Justice (ECJ) has taken a decision or legislation has been passed, it is difficult to undo. This article explains the challenges that created an EU policy arena where none had been; the reasons that decisions taken now will be subject to the logic of path dependency; and the different models that are being put forward for the EU.