Legitimating Health Care Reforms across the EU: Government Narratives of Health Restructuring in England, France, Hungary and Ireland

Explaining the drivers of healthcare reforms against the background of the recent
financial and debt crisis in Europe has proved particularly challenging. While the effects
of the crisis on healthcare funding and provision seems inevitable, notably through a
diffuse pressure to enforce fiscal discipline, it is difficult to detect a change in ideas and
policies following the ‘fast burning’ and ‘slow burning’ phases of the crisis (Seabrooke
and Tsingou 2016). All European countries have faced similar challenges in terms of
ageing population, slow productivity gains, and reduced public resources over the past
three decades. Insofar, healthcare systems had been going through a slow burning crisis
long before the outbreak of the European debt crisis. Furthermore, the common
pressure of austerity does not bring a convergence of welfare systems as its effects are
strongly mediated by domestic politics (Hemerijck et al. 2013).