It is questionable if there has ever been made an attempt to use diplomatic acting, to steer the EU towards a European regional framework. A framework which should only be based on politics used to enforce communicative social systems of networks, and on indicators of health, well-being and happiness of EU citizens
An Ontology of Health and Sustainable Health Regions
By Tomas Mainil*
Associate professor, HZ University of Applied Sciences
Capacity group Health, Governance and Transnationalism
From an outside perspective, the EU can seem like several countries or nation states with different goals and different strategies. It is very difficult for the EU commission to govern these states, or act as an interludium. Historical conflicts have always been embedded within these nation states. It is questionable if there has ever been made an attempt to use diplomatic acting, to steer the EU towards a European regional framework. A framework which should only be based on politics used to enforce communicative social systems of networks, and on indicators of health, well-being and happiness of EU citizens. Power builds at a regional level where regional and city governments have to decide and show vision how to organize and to govern in such a manner that communities of citizens are still encouraged to support the political leadership.
What is the solution to mediate the power display of political decision processes? One possibility is the installment of a framework of sustainable – but also self-regulating health regions in the EU DNA of nation states. Hypothetically , if France and Germany would be organized in a similar set of health regions (Mainil, 2013; Botterill, Pennings and Mainil, 2013), the result would be that in the following years, national borders would become less intrusive in citizens’ lifes, creating a EU space of health regions, not based on political modes of power, but based on a balance of communicative action and strategic action.
To apply this knowledge to an existing case, we see now that Belgium and the Netherlands are slowly moving towards a joint economic agenda. Both countries have recently experienced a new king on the throne of their monarchies, which enforces the national identity of their citizens. Both countries have an efficient health system, different in character, but focused on the provision of health care for their own patients. The quality of their health systems should also enforce the streams of transnational patients to Belgium and the Netherlands, however. Following some recent articles from the New York Times (Rosenthal, 2013), US citizens are choosing to be treated in Belgium. The Dutch province of Zeeland is putting efforts to construct itself as a sustainable health region. We have arrived at a momentum in which health and health care systems are challenged on economic and structural efficiency. The next step could be to use health care as an engine to distribute power more equitably, and to enforce sustainable networks of systemic health regions. One big hurdle are the un-moving movers: medical professionals work in power constellations. This leads to a strategic confirmation of this group of professionals. As transnational health care is being developed, new generations of medical doctors have the choice to engage or to confirm.
This rationale towards a dialogical regionalism is currently only a powerless philosophical stance. Given the need for efficiency and cost budgeting in the national frameworks, however, it could also be seen as a functional tool to formalize governance. The recently adopted EU Directive on the application of patient rights is a EU initiative to regulate patient mobility. We argue that the additional governance structure of sustainable health region development could instigate the further development of the existing regulative framework on patient mobility. The focus of the capacity group Health, Governance and Transnationalism is to assess and test the viability of self-regulating health regions. The first case studies will be executed in the Netherlands and Belgium.
Mainil, T. (2013). Transnational health care and Medical Tourism: Understanding 21st century patient mobility; towards a rationale of transnational health region development. NRIT Media
Botterill, D., Pennings, G. and Mainil, T. (2013). Medical tourism and Transnational health care. Basingstoke, Palgrave Macmillan.
Rosenthal, E. (2013). In Need of a New Hip, but Priced Out of the U.S. The New York Times, august 3
* Dr. Tomas Mainil is Lecturer at Breda University of Applied Sciences (the Netherlands). He is responsible for the research line ´Transnational health care in sending and receiving contexts´ which was originated at the Centre for cross-cultural Understanding (CCU). He is research fellow at the Research Centre for Longitudinal and Life Course Studies (CELLO), University of Antwerp (Belgium). He holds an MA in Sociology (Medical Sociology) and a MSc in Quantitative Analysis, and previously worked at the University of Antwerp (department Sociology) and Ghent University (department of General practice and primary health care) on health-related subjects. His main interests are globalization and health, the policy and governance dynamics of transnational health care (PhD) and the internal and external characteristics of the transnational health user.