• Hans Vollaard, Hester M van de Bovenkamp, and Karsten Vrangbæk.
• Institute of Political Science, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands. vollaard@fsw.leidenuniv.nl
• Health Policy. 2013 Aug 1; 111 (3): 226-33.

AbstractDespite the fact that Member States and many citizens of the EU like to keep healthcare a foremost national competence and the EU treaties state that Member States remain primarily responsible for the organization and delivery of health care services, the European Union (EU) has expanded its involvement in healthcare policy over the last twenty years. Based on interviews and document and literature analysis we show that the scope of EU involvement has widened from public health and access to care, to quality of care. In this paper we concentrate on the latter. Focusing on the recent EU initiatives regarding the quality systems of the Member States and the quality of services, this paper shows how the depth of EU interference has increased from sharing information to standardization and even to the first signs of enforcement. We argue that at this stage, reflection on the feasibility and desirability of the EU's involvement is clearly needed, also considering the differences in quality of care policies between and within EU Member States. Both arguments in favour and against further EU involvement are discussed in this paper.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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