Dear Madam President of the European Commission,
I always listen to the State of the Union address with great expectation. I believe in Europe and am confident that European institutions are our best way to guarantee peace, a social model of prosperity and inclusion, and the competitiveness of our economies.
The challenges are enormous, and while remaining faithful to the Treaties, meeting the legitimate expectations of citizens is a difficult task in a geopolitical environment with highly aggressive counterparts, differing positions among Member States, and a world that is inexorably accelerating.
What I also know is that health remains a major concern for Europeans.
In this year’s speech, you said that: “Europe must also take the lead on global health. We are on the brink – or even at the start – of another global health crisis. As a medical doctor by training, I am appalled by the disinformation that threatens global progress on everything from measles to polio. And this is why today I can announce that the EU will head a new Global Health Resilience Initiative. Because the world is looking to Europe – and Europe is ready to lead.”
I believe this is insufficient. The problem lies not “only” in the global risk but also in the lack of responses to citizens.
That is why I listened to your 2020 State of the Union speech again.
We were all still wearing masks and everyone was focusing on health, so it was with hope that I heard your determination: “For me, it is crystal clear – we need to build a stronger European Health Union,” adding later that “it is clearer than ever that we must discuss the question of health competences. And I think this is a noble and urgent task for the Conference on the Future of Europe.”
Five years later, progress falls far short of what is needed, and in several member countries, we see a deterioration in the conditions of healthcare systems.
We are all aware of the competences set out in the Treaties, but the real question is whether European citizens truly feel the existence of a European Health Union when we see completely restricted markets, investment and activity rules that undermine free enterprise, and the imposition of economically inefficient and discriminatory prices.
The competence of each member state to create and manage its healthcare system is not in question, but European citizens hope that this vital sector will not be treated as a minor topic, without a strategy, without clear rules, and too often marked by ideological bias. And also in economic terms, as the Draghi Report recognizes, the healthcare sector must be a pillar of Europe’s competitiveness.
We are all needed to address the challenges of healthcare (shortages of healthcare professionals, an aging population, the digital transition and AI, and global risks).
Europe’s private hospitals stand ready to collaborate, with investment capacity, management flexibility, and the potential for efficient expansion of provision.
We all need to work together. We all have a role to play. The European Health Data Space is an excellent example of how public and private providers must work together because the health of citizens is at stake. Therefore, European programs and measures should not discriminate based on the nature of hospitals. The same could be said about hospital cybersecurity because it is the protection of the entire system that we need and private hospitals must be involved.
To ensure universal coverage, which must be shared by each health system but also by Europeans as a whole, it must be recognized that providing healthcare is highly demanding in terms of investment, planning, and management. This requires clear and non-discriminatory financing rules (with public institutions having different remuneration or compensation mechanisms), because otherwise, sustainability is at risk.
Therefore, Madam President, also as a physician and former Minister of Health, I urge you to take concrete steps toward the European Health Union. The sustainability of healthcare systems, the well-being of Europeans, and Europe’s competitiveness are at stake.
Oscar Gaspar, President of UEHP
Read the full version of the October 2025 newsletter
