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This chapter reconstructs developments of EC law (including case law) relating to social protection, and traces the differential impact that free movement and competition rules have had on the various functional schemes and tiers or pillars of provision within national welfare states. It also identifies and illustrates the new strategies of spatial politics prompted by the boundary redefinitions operated by the EU, focussing on pensions (including pension funds), health care, and social assistance. Special attention is devoted to the position of third country nationals.

This chapter elaborates the fragmentation of health care delivery systems in the European Union (EU). It reviews the content of the complex legal rules requiring EU Member States to reimburse citizens for health care received in other Member States. The EU Regulations on social security have placed the right of European citizens to move, work, and reside within the Union into practice. The codification of the “second track” of statutory entitlement to benefits for planned cross-border health care in the EU is the central part of the Patient Rights' Directive. This Directive has several advantages for patients who look for health care services abroad or have received such health care. In general, the new EU Directive on the application of patients' rights in cross-border health care is a first step to facilitate access to safe and high-quality cross-border health care in the EU and to ensure patient mobility throughout Europe.

This chapter examines developments regarding EU legislation in the area of health care, rather than public health. The chapter is a case study looking into the processes and the involvement of different EU institutional actors and policy mechanisms in the adoption of the Directive on patients’ rights in cross-border health care (‘the Directive’). First, the chapter introduces the Directive itself, and considers whether it expands access to health care across the EU. Second, it turns to the way the Directive was adopted, focusing particularly on the different roles of EU institutional actors and the discourse and controversies that developed in health care in the EU as a result of the legislative process. Last, the chapter addresses the expansion of EU health-care policy beyond the adoption of the new Directive that resulted from the increased discourse on health care and its impact for individual rights and access to health care.