Is the equity of access to health care a European constitutional standard? A comparative review (original) (raw)
Recognition of the right to health in the international law and national constitutions was one of the most significant symptoms of development of postwar welfare states in Europe. Equity of access to health care became an underpinning principle for the policies and legislation of the states gradually expanding their responsibility for health services delivery. Welfare state crisis resulting from austerity policies creates particular risk to health care systems around Europe. It escalates pressure for reducing state's responsibilities and weakening the guarantees of accessibility and quality of health services. One of the most effective barriers to this tendency towards rolling back the welfare systems might be strong constitutional standard of right to health. This article reviews the constitutional acts of 28 European Union Member States in order to explore the scope of protection of the right to health, with special focus on various aspects of equity of access to health care. Three major models of regulation are identified: a) limited to enshrining right to health; b) enacting right to health and putting additional emphasis on specific dimensions of this right, e.g. equality in access or affordability; and c) enshrining right to health care and establishing key principles governing the health care system, e.g. funding scheme for health services provision. What is more, this review shows also the absence of universal European standard of the constitutional regulation of this matter and describes major differences relating to formulation, level of protection guaranteed and material scope of regulation. In conclusion, a hypothesis is proposed on the potential role of constitutional guarantees in preventing the deterioration of accessibility of health services.
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