Political Territoriality in the European Union

Transcription

1 Political Territoriality in the European Union The changing boundaries of security and health care Hans Vollaard

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3 Political territoriality in the European Union The changing boundaries of security and health care Proefschrift ter verkrijging van de graad van Doctor aan de Universiteit Leiden, op gezag van Rector Magnificus prof. mr. P.F. van der Heijden, volgens besluit van het College voor Promoties te verdedigen op donderdag 11 juni 2009 klokke uur door Johannes Paul Vollaard geboren te Amersfoort in 1977

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5 Promotiecommissie Promotores: Prof. Dr. P. Mair Prof. Dr. A. van Staden Co-promotor: Dr. R.B. Soetendorp Referent: Prof. Dr. J. Zielonka (Oxford University) Overige leden van de promotiecommissie: Prof. Dr. M.G.W. den Boer (Vrije Universiteit van Amsterdam) Prof. Dr. R.T. Griffiths Prof. Dr. K. Koch Printed by Drukkerij Groen, Leiden Cover design: Johan Selier

6 Contents List of tables x Acknowledgements xiii Chapter 1 Making political territoriality variable Political territoriality beyond Westphalia The golden age of territoriality theory? Research on politics and territory until the 1980s Politics and territory in International Relations: neo-realism and globalisation Politics and territory in other research fields An empirical impression of changing political territoriality 20 Chapter 2 Conceptualising political territoriality A political strategy, not an instinct The social construction of (non-)territorial boundaries and space Sack s understanding of political territoriality and its implications The logic of political territoriality Geographical fixity Impersonality Geographical exclusivity/ inclusion Geographical centrality Anarchy, functional differentiation, and (geographical) distance Tracing changing political territoriality Time and territory Conclusion 64 Chapter 3 Comparative territorialities Mapping unit variation The ideal type state: the logic of territoriality in extremis (Con)federation: conflicting territorialities or consociationalism Network governance: spatial functionality Political territoriality and a (neo-mediaeval) empire What is the European Union? 86 Chapter 4 Explaining changing political territoriality in the European Union The improbability of France 87

7 Contents 4.2 French history of territorial integration Theoretical lessons learned from French polity-formation and boundarymaking The territorial trap in EU studies Rokkan, Hirschman, and Bartolini Exit, voice and loyalty No functionalist determinism Political territoriality and polity-formation 117 Chapter 5 Political Territoriality and European (dis)integration Will the European Union survive until 2014? The territorial bias in theories of European integration Realism Federalism (Neo-)functionalism Transactionalism Communitarianism Theories of decline and fall of empires European (dis)integration and political territoriality until the 1980s From the 1940s until the 1960s: Establishing a Euro-polity : the first wave of external de-consolidation : the second wave of external de-consolidation Political territoriality in Europe in the 1980s European (dis)integration and political territoriality until the 1980s A third wave of external de-consolidation Propositions Europe s morphology 167 Chapter 6 Territoriality and the geography of threats Introduction Avoiding the territorial trap in security studies Political territoriality and organising security in history Territorialisation of security Controlling masterless men Territorial defence after the Second World War: an illusion? A European security system in the making? West-European exits from the US security empire? Breaking through the logic of territoriality of local and national security systems? Security before 1989: multi-layered, territorial and non-territorial strategies 219 Chapter 7 Political territoriality and security in the European Union and the Netherlands 223 vi

8 Contents 7.1 Introduction The redefinition of security threats in the European Union and the Netherlands Keeping security threats out of the European Union The creation of European boundary control Outward-looking and value-based security policies of the EU Dutch security policies in European perspective I Keeping security threats down in the European Union Dutch security policies in European perspective II The creation of a Area of Security, Freedom and Justice at European level Security and territoriality in the Netherlands since the 1980s Conflicting territorialities: national/european Personalisation of boundary control Partial exit by interface regions European integration and conflicting territorialities: national/local Terrorism: centralisation and nationalism The morphology of Europe s organisation of security The territorial trap avoided 305 Chapter 8 The territorial closure and the European opening of the Dutch healthcare state Introduction The territorial underpinnings of healthcare states Territorial closure Two families of healthcare states Centralisation in the Dutch healthcare state European exit options from European healthcare states Regulation 1408/ The Single European Act INTERREG: exit options in border regions Euregion Meuse-Rhine Other border regions The European Court of Justice creates another hole in the fence The European Health Insurance Card propositions 343 Chapter 9 Cross-border patient mobility in the European Union and the Netherlands Introduction Attempts to keep the healthcare states closed at EU level After Kohll and Decker: a deafening silence Patient mobility officially on the European agenda DG Internal Market vs. DG SANCO 353 vii

9 Contents 9.3 The Dutch healthcare state after the Kohll and Decker rulings The Euro-compatibility of the contracting system Dutch waiting lists and cross-border healthcare Cross-border healthcare: more than a temporary safety valve? Moves and motives of patients (Voicing) dissatisfaction about waiting lists Patients exit? Patterns of cross-border patient mobility Competing territorialities in the EU A European healthcare territory in the making Unfreezing state territoriality Voice vs. choice 401 Chapter 10 Conclusion Essential and variable The EU is not going beyond territoriality Mobile vs. immobile citizens Imperialism and disintegration 417 Annex I: Samenvatting (summary in Dutch) 419 Annex II: List of Interviewees 443 Annex III: Primary sources 445 Bibliography 457 Curriculum Vitae 477 viii

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11 List of tables Table 1: Public satisfaction with the Dutch healthcare system, p Table 2: Attention to healthcare waiting lists in Dutch newspapers, p. 379.

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13 Acknowledgements Writing a PhD dissertation on political territoriality in the European Union is like learning to play the trombone well. Exploring relatively new conceptual ground requires at least as much discipline and time as practicing this instrument. Fortunately, the Department of Political Science at Leiden University offered me the opportunity to chart the world of territoriality, even though it was initially unclear what this would eventually bring about. Friends and colleagues, among others Joop van Holsteyn, Koen Koch, Willem-Jan Lammers, Hans Oversloot, Huib Pellikaan, and Niels van Willigen have been sources of inspiration and reflection for helping me compose the dissertation. I would like to express my deep gratitude to Maarten Vink for years of good company, for showing me how to become a good political scientist, and for sharing interest in tiny political entities across the world. A great variety of academics have written on certain aspects of political territoriality, from post-structuralists to health policy experts, and from political geographers to historians. It has been quite a challenge to create harmonic melodies from this cacophony of voices. The participants from the Public Administration/ Political Science PhD seminar at Leiden University, the courses of the Netherlands Institute of Governance (NIG), and the NIG colloquium on Europeanisation led by Markus Haverland and Ronald Holzacker have been very helpful for staying in tune with the methodological and theoretical requirements of the discipline. Richard Griffiths placed his trust in me as a beginning academic to organize conferences and publish books on political territoriality and related issues in the EU studies programme at the Leiden Faculty of Arts, for which I am deeply thankful. Furthermore, I am indebted to all participants of those conferences, and in particular Michael Burgess, for discussing some of the fundamental aspects of European politics. I would also like to thank all my students, particularly those attending my MA course on political territoriality, who have been a responsive audience for testing my ideas. The interviewees have been willing to share their comments and ideas without hesitation on several occasions. They have been indispensable to me for gaining better insight

14 into the daily practices of healthcare and security policies. I would also like to express my gratitude to those others I failed to mention who have helped me create a more harmonious symphony on political territoriality in the European Union. No program is available for the concert of life, as a well known Dutch cliché says. I have enjoyed the program so far, including the PhD symphony, also because I could always count on the love and support of my parents. The accompaniment of my brothers, the Matthew Locke Brass Ensemble, Evert-Jan, Filip and other friends has made my life as a PhD candidate light and bearable. I am looking forward to the next piece on the program! Hans Vollaard Leiden, spring 2009 xiv