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Bringing EU citizens together or pulling them apart? The European Health Insurance Card, east–west mobility, and the failed promise of European social integration

Stan, Sabina orcid logoORCID: 0000-0003-1602-0519, Roland, Erne orcid logoORCID: 0000-0003-2791-4454 and Susan, Gannon (2020) Bringing EU citizens together or pulling them apart? The European Health Insurance Card, east–west mobility, and the failed promise of European social integration. Journal of European Social Policy, 31 (4). pp. 409-423. ISSN 0958-9287

Abstract
Although the European Health Insurance Card (EHIC) was meant to bring Europeans together, this study shows that it is amplifying social inequalities across regions and classes. First, we evaluate the effects of east–west EHIC mobility, and of Eastern Europeans’ participation in it, on the practice of EU social citizenship rights to access cross-border care along spatial (east–west) and social class divides. We then assess the impact of these mobilities on healthcare resources in Western and Eastern Europe. Our findings show that the EHIC reinforces rather than reduces the spatially and socially uneven access to social citizenship rights to cross-border care. Moreover, EHIC patient outflows from Eastern to Western Europe result in a much higher relative financial burden for the budgets of Eastern European states than outflows from Western to Eastern Europe do for Western European countries. As a result, east–west EHIC mobility is reproducing rather than reversing healthcare inequalities between the two regions. Hence, the EHIC does not fulfil its promise of European social integration – not, however, because it creates a burden on Western European welfare states as often argued in Eurosceptic tabloids, but because it increases social inequalities both inside and between richer and poorer EU member states.
Metadata
Item Type:Article (Published)
Refereed:Yes
Uncontrolled Keywords:European Integration; social integration; healthcare; cross-border care; benefit tourism; patient mobility, labour migration; uneven development; ;
Subjects:Social Sciences > Globalization
Social Sciences > International relations
Social Sciences > Political science
Social Sciences > Sociology
Social Sciences > Tourism
Social Sciences > Migration
Social Sciences > Public administration
DCU Faculties and Centres:DCU Faculties and Schools > Faculty of Science and Health > School of Nursing, Psychotherapy & Community Health
Publisher:SAGE Publications
Official URL:http://dx.doi.org/10.1177/0958928720974188
Copyright Information:© 2020 Sage Open Access (CC-BY-NC- 4.0)
Funders:European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme, grant agreement No 725240 (Erne 2018)
ID Code:25095
Deposited On:11 Dec 2020 15:10 by Sabina Stan . Last Modified 12 Nov 2021 14:48
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