Dutch health system reforms can be characterized by an ambiguous approach, combining competition and private initiatives on several health care markets with restrictive measures inspired by social values. Respecting equal access to necessary health care services on a competitive market appears to be an extremely difficult and bureaucratic exercise, if not impossible.
This paper examines the right to health care. Various expressions of this right may be distinguished. These include both individual rights and social rights which could be based upon international treaties and constitutional rights. They may be found in national health legislation and, in some cases, in jurisprudence. To analyze the consequences of limiting the right to health care, a framework for judicial review has been developed which encompasses these expressions of the right to health care. The framework was used to examine legal and health policy developments in three Western and two Eastern European countries. In Italy and the Netherlands the right to health care is protected constitutionally (but on differing legal bases) while the United Kingdom does not have a written constitution. In contrast, Hungary and Poland have for many years seen the state take responsible for the provision, administration and allocation of health care services and the right to health care was guaranteed theoretically but not in practice because of the lack of (financial) means. However, the Polish Constitution explicitly anticipates possible limitations of the right to health care. What all these countries have in common is a cost containment perspective where the future will bring even tighter limits on what resources patients may consume. Despite differences in legal structure between these countries, where they seem to converge is on the consequences of putting limitations on the right to health care. The courts in Italy, the Netherlands and the UK have formulated conditions drawn from the acceptance that this right has to be judged within the context of limited resources. It may be concluded that finding a compromise between the right to health care and cost containment policies could also be an issue, Eastern European countries will have to face in the future.
New treatment options for various cancer therapies appear to be extremely expensive and prices may increase further. The affordability and availability of life-saving medicines is therefore a key issue in the national health policies of all countries. International and European law grant several price-reducing options, including compulsory licensing. Still, countries are reluctant to apply for compulsory licensing and/or other regulatory options to curtail pharmaceutical prices. Why is that? Evaluating the options will support health policy decision-making on safeguarding access to affordable innovative medicines.
For decades, the European Court of Human Rights (ECtHR) has applied a restrictive interpretation on the Article 3 threshold in extradition cases. The removal of aliens from the contracting state is lawful unless the applicant faces an imminent risk of death (D v. the United Kingdom (St Kitts)). However, with the Paposhvili ruling the Court has lowered the deathbed requirement to a more favourable standard as confirmed in the latest Savran case. But will those facing medical expulsion really benefit from this new standard at national level?