A Difficult Encounter : National Healthcare Models and the European Union

This paper examines the institutional output and preliminary outcome of the European Union (EU) Patients' Rights Directive in two healthcare models: the Beveridge and Bismarcian models in Denmark and Bulgaria, respectively. The study applies a most dissimilar system design to explain a similar transposition output through three explanatory variables, namely, institutional misfit, salience and administrative resources. We find that Denmark and Bulgaria have transposed the Directive in protectionist and minimalistic ways, thus far leading to a low outcome, i.e., low patient outflow. The encounter between the European Union (EU) and the national healthcare models has not been enthusiastic but has instead been another example of reluctant and restrictive Europeanisation