The difficult case of healthcare cooperation across borders : German–Polish bilateral arrangements in the light of previous European borderland experiences

Abstract

This chapter discusses the state of Polish–German bilateral relations on healthcare and health policy, focusing on the potentials and practices in the regions and municipalities situated close to the border. Reviewing actions taken, discussed or highlighted by Euroregions, twin towns, intergovernmental bodies and media, the chapter finds that the overall activity level in this field is low compared to other policy sectors, even though there are signs of increased cooperation. The analysis shows that the cross-border integration and bilateral relations in the health sector are impacted by the asymmetric resources on the respective sides of the borders. This has largely spurred an increase in private exchanges but hindered the effective development of integrated public services at the local level. This is related to the notions of interdependence, whereby actors and citizens do not perceive their health or health sectors to be affected by their neighbours’ activities, despite larger global and systemic interdependence that concerns human health. The analysis also demonstrates that historical legacies have relatively little importance in the area of healthcare. At the subnational level, the lack of social capital and the difficulties local cross-border actors have in efficiently working the multilevel governance scales were found to be key obstacles.