Solidarity as a Political Determinant of Health: Insights from EU Competition Policy

Context: The connection between law and political determinants of health is not well understood,but nevertheless it is suggested that the two are inseparable, and this represents an upstream levelwith scope for influencing other determinants of health (particularly social determinants). Soli-darity underpins European health care systems, and given its clear link with redistribution, it can beseen as a means for addressing health inequities. As such, solidarity may be seen as a politicaldeterminant of health in the specific context of European Union (EU) competition policy.Methods:A range of EU case law, treaty provisions, and European Commission publicationsrelating to EU competition policy are analyzed.Findings:Solidarity is typically juxtaposed as antithetical to competition and thus as underpin-ning exceptions to the applicability of prohibitions on anticompetitive agreements, abuse ofdominance, and state aid. Case law indicates an additional dynamic between definitions of soli-darity at the EU and national levels.Conclusions:This analysis leads to two groups of considerations when framing solidarity as apolitical determinant of health in the EU competition policy context: first, the predominance ofsolidarity suggests it may shape competition reforms; second, the EU-member state dynamicindicates less EU-level reach into national competition reforms in health care than may beexpected.