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- PublicationThe New Economic Governance in Health Care: A Labour PerspectiveUp to the 2008 financial crisis, the rise in the EU’s role in healthcare policy-making was mostly the result of market integration, most notably in the area of cross-border care. This largely safe-guarded member states’ competence in that field by eschewing the EU’s direct intervention in national healthcare policies to the benefit of indirect, horizontal market constraints. Since the 2008 crisis, the development of the EU’s New Economic Governance (NEG) has challenged this situation. Indeed, the NEG introduced direct intervention in social policy-making at large, including, more specifically, in healthcare. In this paper, we will look at the new economic governance in healthcare and its impact on labour politics in the sector. We will do so by mapping: 1) the nature and extent of NEG interventions in healthcare; by taking into account 2) the impact of these interventions on the space of action and power resources of trade unions and social movements active in the healthcare sector; and 3) the extent to which NEG interventions offer points of crystallisation for transnational collective action.
- PublicationTowards an Integrated European Healthcare Space?While health services have long been insulated from the process of European integration, this article shows that we are witnessing their re-configuration in an emerging EU healthcare space. The article uncovers the structuring lines of this space by focussing on three interrelated processes that contribute to linking national healthcare systems into a larger EU-level one: 1) indirect vertical pressures linked to the rise of a new capitalist accumulation regime and the constraints of both the Maastricht economic convergence and the EU accession criteria; 2) horizontal market pressures linked to the free movement of health services, workers and patients within the European Single Market; 3) direct political pressures linked to new EU laws and New Economic Governance prescriptions that the EU has been issuing since the financial crisis of 2008. The article shows that these processes have helped constructing a European healthcare space that is uneven in terms of the distribution of access to services by patients and of wages and working conditions of healthcare workers, but similar in terms of economic and financial governance pressures within and across EU member states.
- PublicationA new methodology for analysing NEG prescriptions on healthcare. From counting CSRs to mapping semantic fieldsThis is a first draft of the methods and methodological considerations which we drew on in analysing New Economic Governance policy prescriptions in the area of healthcare. The text details the steps we took in defining and analysing my units of analysis as well as the methodological foundation on which these definition and analysis are based.
- PublicationEuropean collective action in times of crisisThis introductory article to the special issue proposes a more encompassing view of transnational collective action in Europe, which goes beyond the classical, country-by-country oriented, comparative industrial relations approach. Instead, we propose an extension of focus to capture also other actors, action repertoires, places and levels. Specifically, we introduce and integrate the contributions to this issue, by extending our analytical perspectives from traditional forms of employment to precarious and posted workers; from national and European trade union structures to informal groups of workers and social movements; from unions’ traditional strongholds in manufacturing multinationals to workers in the meat industry, health care or occupied factories; from national unions seen as coherent units to a perspective that emphasizes their internal contradictions; from the analysis of discrete actions to historically more encompassing perspectives; and from utilitarian views on collective action to a larger perspective that assesses the analysis of the importance of collective struggles for the making and unmaking of a new European working class.
- PublicationExplaining Romanian labor migration: from development gaps to development trajectoriesWhile migration scholars often neglect the national and transnational relations of production and exchange within which labor migration occurs, international political economists tend to treat labor migration as a mere side effect of transnational capitalism. By contrast, this article considers the constitutive role that post-socialist transformations and the EU integration played in shaping the various patterns of intra-European east–west labor migration since 1989. We argue that labor migration was not driven by development differentials between the west and the east as such, but rather by the particular type of development the latter adopted after the fall of communist regimes and by the way post-socialist countries were integrated in transnational circuits of production and exchange. We are sustaining our claims by a comparative assessment across time of the articulations between the different modes of production and different labor migration patterns during different stages of Romania's post-socialist transformation. This historical comparison enables us to insulate the influence of changing levels of development and modes of production on labor migration because our focus on a single country is keeping the influence of other national institutional factors constant.
810Scopus© Citations 26
- PublicationTime for a paradigm change? Incorporating transnational processes into the analysis of the emerging European health-care systemHealth services have long been insulated from the process of European integration. In this article, however, we show that we are witnessing their re-configuration in an emerging EU health-care system. The article uncovers the structuring lines of this system by focusing on three interrelated EU-wide processes influencing the integration of national health-care systems into a larger whole. First, the privatisation of health-care services following the constraints of Maastricht economic convergence and the EU accession criteria; second, health-care worker and patient mobility arising from the free movement of workers and services within the European Single Market; and third, new EU laws and country-specific prescriptions on economic governance that the EU has been issuing following the 2008 financial crisis. The article shows that these processes have helped to construct a European health-care system that is uneven in terms of the distribution of patient access to services and of health-care workers’ wages and working conditions, but very similar in terms of EU economic and financial governance pressures on health care across EU Member States.
93Scopus© Citations 2
- PublicationIs migration from Central and Eastern Europe an opportunity for trade unions to demand higher wages? Evidence from the Romanian health sectorIndustrial relations scholars have argued that east-west labour migration may benefit trade unions in Central and Eastern Europe. By focusing on the distributional aspect of wage policies adopted by two competing Romanian trade unions in the healthcare sector, this article challenges the assumption of a virtuous link between migration, labour shortages and collective wage increases. We show that migration may also displace collective and egalitarian wage policies in favour of individual and marketized ones that put workers in competition with one another. Thus, the question is not so much whether migration leads to wage increases in sending countries, but whether trade unions' wage demands in response to outward migration consolidate collective solidarity and coordination in wage policy-making or support its individualization and commodification.
699Scopus© Citations 18
- PublicationBringing EU citizens together or pulling them apart? The European Health Insurance Card, east–west mobility, and the failed promise of European social integrationAlthough 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.
271Scopus© Citations 7
- PublicationBringing society back into our understanding of European cross-border careWe are pleased to discuss our study on the European Health Insurance Card (EHIC) and the redistributive effects of EHIC-related east-west patient and payment flows across regions and social classes. Our critics confirm our key finding: EHIC patient outflows from Eastern European (EE) to Western European result in a much higher relative burden for the budgets of EE states than outflows from WE to EEE do for WE countries. Starting from what they see as the true mission of social security coordination, however, they also tell us that we should never have studied the redistributive impact of EHIC patient and payment flows in the first place. In this response, we therefore explicate the differences between our empirical sociological perspective and our critics' normative legal approach. This is important, especially when social facts contradict normative legal assumptions as in our case. The EU laws that govern EHIC patient and payment flows are indeed based on the free movement provisions of the EU's internal market project, but our empirical findings show that its promise of "economic, social and territorial cohesion, and solidarity among Member States' contained in Article 3.3. of the Treaty of the European Union is not realized in practice in the case of east-west EHIC payment flows and patient mobility.