Chapter 4: Citizens, Consumers and Stakeholders in European Health Policy
Meri Koivusalo and Jonathan Tritter In this chapter we track emerging issues in public participation and involvement in European policymaking. We focus on the politics, legitimacy and accountability of different actors as well as exploring how European participation processes relate to globalization in general and global and regional governance in particular. Health policies tend to be understood as national or even local, yet they are often shaped and defined by regulatory decisions and policies that are determined globally and regionally. EUROPEAN UNION AND HEALTH Governance in the European Union (EU) is based on legal treaties and founded on the protection and promotion of the ‘Four Freedoms’ – the free movement of goods, capital, services and persons – which are understood as fundamental to the maintenance of a common market. These treaties define the basis on which the European Commission can undertake initiatives and propose regulatory action in the form of directives. While the European Commission can initiate actions, these need to be approved by the Council of the European Union and the European Parliament. In principle, citizens in the EU are represented both through their own governments, which are members of the Council of the European Union, and their elected representatives in the European Parliament. However in terms of democratic governance a deficit can be identified at the European level, particularly in relation to executive powers. This has been part of a European discourse on civil society since the Maastricht Treaty of 1992. Health policies have traditionally been part of national policy....
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