欧盟跨境医疗政策的积极一体化——超国家力量和国家力量间的双向调适  

The Positive Integration of EU Cross-Border Healthcare Policy——A Bidirectional Adjustment between Supranational and National Powers

作　　者：刘涛 刘木兰[1] LIU Tao;LIU Mulan

机构地区：[1]浙江大学公共管理学院 [2]浙江大学社会治理研究院 [3]中山大学中国公共管理研究中心

出　　处：《欧洲研究》2025年第1期135-154,I0005,共21页Chinese Journal of European Studies

基　　金：教育部人文社会科学重点研究基地中山大学中国公共管理研究中心课题“共同富裕时代人民美好生活需要与社会政策创新研究”(批准号:22JJD630021);中央高校基本科研业务费专项资金“共建共治共享的多层次社会保障体系建设实践研究”(S20230211)的资助。

摘　　要：随着欧洲统一市场的建立与威斯特伐利亚体系下主权国家边界的逐步淡化,欧盟公民自由且频繁的跨境流动催生了对国民医疗保障权利可跨国转移的需求。一方面,该现象对福利国家的医疗保障供给闭环带来了冲击,各国通过调整国内制度以应对境内患者的“流出”与境外患者的“闯入”;另一方面,欧盟通过立法协调成员国政策。虽然欧盟具备较强的超国家整合能力,但缺乏在医疗保障制度跨国协调方面的国家行动能力;成员国虽然会积极地将欧盟的相关立法内化为国内法规,但欧盟在法律执行过程中遵循主权共管原则,医疗保障领域的权能仍然归成员国所有。由于超国家行动能力的局限性与国家能力的不均衡分布,使欧盟跨境医疗政策出现了“去一体化”迹象,有些成员国已着手采取相关措施。欧盟的超国家行动能力在短期内难以得到显著提升,其跨境医疗政策的深化面临诸多困境。With the establishment of the European Single Market and the gradual dilution of the sovereign borders of a state under the Westphalia system,the free and frequent cross-border mobility of EU citizens has attached the right to healthcare coverage granted to nationals by the welfare state with a transnational transferable attribute. On the one hand,this phenomenon has impacted on the closed loop of the welfare state 's healthcare provision and the member states have adjusted their domestic systems to cope with the ‘outflow'of patients from within the country and the ‘influx'of patients from outside the country. On the other hand,the EU has adopted legislation to coordinate its member states' policies. However,in spite of the EU's powerful integration capacity at the supranational level,it lacks the capacity for national actions in coordinating the healthcare system across borders. At the same time,the EU follows the principle of shared sovereignty in the implementation of such legislation,and the competencies in the field of healthcare remain under the authority of the member states. Due to the limitations of supranational capacity for actions and the uneven distribution of national capacities,the EU 's cross-border healthcare policy has shown signs of de-integration,and some member states have begun to take countermeasures. As the supranational power of the EU can hardly be significantly enhanced in the short term,it is impossible for the EU to deeply promote the integration process of its cross-border healthcare policy.

关 键 词：欧盟 跨境医疗 医疗保障 积极一体化 

分 类 号：D814.1[政治法律—国际关系] D99[政治法律—政治学] R199[政治法律—外交学]