The COVID-19 pandemic has prompted debates on stronger European health policy cooperation. In Germany, the EU’s most populous country and strongest economy, which holds a general election on 26 September, political parties are divided over whether and how the EU’s role should be strengthened.
Ahead of the vote, parties’ stances range from support for additional EU competencies to concerns that deeper cooperation would undermine the national healthcare system.
Health competency is currently in the hands of member states but the European Commission has presented plans for a stronger European Health Union that would deepen cooperation in various areas.
Work on the package will likely continue during the coming months, as the Slovenian presidency of the EU Council aims to kick off trilogue talks with the European Parliament and the Commission.
Health Union and common data space
“The time is ripe for a European Health Union,” a German Green Party spokesperson told EURACTIV. “The EU’s health competencies (…) need to be expanded – even beyond the current legislative framework,” the spokesperson added, citing the need to prepare for future health crises.
This would include strengthening EU-wide data networking and harmonising national approaches to health care issues.
As the only major party to call for additional EU health competencies, the Greens are at odds with the liberal FDP – a possible coalition partner, for example in a “traffic light” coalition (Social Democrats, Greens, FDP).
“It is important that the EU does not overstep its competencies,” an FDP spokesperson said. “While we want to strengthen research and voluntary cooperation on the EU level, we are sceptical about a Health Union or a European Data Space if this implies significant interference with national health systems,” the spokesperson added.
Data Space refers to a legislative initiative by the Commission to establish an interlinked system to exchange health data across the EU.
The Left Party also has mixed feelings on the matter.
A Die Linke spokesperson said that “there are areas where deeper cooperation is advantageous” but stressed the party would not support any initiative that destabilises national health systems.
The current ruling parties, the Christian Democrat CDU/CSU and the Social Democrat SPD, place themselves somewhere in between and are likely to support relative continuity of Germany’s position, which favours stronger health cooperation.
CDU/CSU, who currently hold the health ministry, told EURACTIV they will push for the ongoing work on a European Health Union “to be completed speedily” in order to improve pandemic preparedness.
Meanwhile, the Social Democrats said the pandemic had shown the need to strengthen EU healthcare cooperation, including the Commission’s plans for a European Data Space.
“Our long-term goal is an interoperable infrastructure that allows patients from Tallinn to Thessaloniki and Faro to access their health data and share it with local doctors,” their spokesperson explained.
Stronger European agencies
Several parties also voiced support for another building block of the Commission’s Health Union plans: strengthening the EU agencies for infectious disease (ECDC) and medicines (EMA).
“The ECDC and EMA need to be permanently strengthened, in order to coordinate the prevention and reaction plans for this and future epidemics together with national health agencies,” the Greens said.
While CDU/CSU also said that stronger European agencies would create “clear EU added value,” they cautioned that “detailed assessment and debate” would be necessary to clarify where the EU’s competencies on health issues end.
Both parties also vowed to support the ongoing work on building up a European authority for health emergency preparedness and response (HERA).
Beating cancer, promoting research
Another component of the Health Union is the Commission’s Beating Cancer Plan, which it presented in January 2021.
With 2.7 million people diagnosed with the disease in 2020 alone, Europe accounts for almost a quarter of global cancer cases.
German parties agree that the issue must be addressed and cancer research ramped up, but are split on how to approach this.
“Cancer research is a priority for the SPD,” the Social Democrats told EURACTIV. Among other things, this would mean promoting EU-wide cooperation between different strands of research, they explained.
CDU/CSU want to harmonise research regulations throughout the EU. “We will speed up the development of new medicines by creating consistent legal requirements throughout Europe,” they said.
The Liberals also stress the importance of cancer research but would promote it mostly through deregulation, including on new genomic techniques like “CRISPR-Cas9”.
“We oppose broad-brush bans and call for a fact-based, unprejudiced assessment,” an FDP spokesperson told EURACTIV, saying the party wanted an open debate about opportunities and risks of new biotechnologies.
To harmonise medical research throughout the EU, the party also wants to establish a European Agency for Disruptive Innovation.
On the opposite end of the spectrum, the Left wants to expand public medical research. “We especially need research on therapeutic procedures that are (…) not attractive for commercial research,” they said, adding that the EU could play an important role in this area.
Similarly, the Greens want to invest in medical research and “create alternative incentives where market incentives for the development of therapies are insufficient”. Moreover, they called for stronger European coordination on medical research and production.
All parties cautious about European HTAs
On one issue, however, there seems to be relative agreement, as all parties appear very protective of national competencies when it comes to cooperation on health technology assessments (HTA).
Such assessments form the basis for decisions on the value of new technologies as well their pricing and reimbursement by health insurers or health systems.
In June, the European Parliament and the Council reached an agreement on European HTA cooperation, foreseeing a member state coordination group that can issue joint HTAs.
After staunch resistance against mandatory EU-level HTA by a number of countries including Germany, however, the group’s assessments are non-binding for member states – and German parties made clear they intend to keep it that way.
“In general, we support a stronger harmonisation of HTA, but (…) under no circumstances can this imply lowering standards for the assessment in Germany,” the SPD told EURACTIV, although they welcomed the agreement on voluntary coordination, saying it promised “streamlined structures and better exchange between member states”.
Similar sentiments are echoed by the other parties. While all supported voluntary cooperation, they unanimously opposed any binding interference with national procedures.
[Edited by Natasha Foote/Zoran Radosavljevic]