La Croix: Many blame the European Union for its lack of response to the epidemic. Do you think this criticism is justified?
Enrico Letta: Yes, if it is addressed to national leaders who have been slow to grasp the gravity of the situation and who have shown their selfishness and their divisions. No, if it targets the institutions, in particular the Commission and the European Central Bank, which have reacted with speed, determination and efficiency. Especially if we take into account that health policy is an exclusive competence of the Member States, the Union only intervenes in support.
Can the crisis be an opportunity to put in place a real common health policy?
E.L.: We think that Europe is all-powerful, that it decides everything. Then, suddenly, we discover that in an area as essential as health, it has only a limited capacity for initiative.
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Let us hope that this crisis will force us to move forward. Europe is always built in stages. In recent years, it has acquired new instruments to deal with the financial crisis, the migration issue, the terrorist threat. Building a true Europe of health must be one of the main objectives for 2020. Faced with diseases that mock borders, “everyone at home, everyone for themselves” does not work.
What priority issues must this Europe of health advance?
E.L.: The question of the health market is essential: centralizing the purchase of drugs and equipment makes it possible to reduce costs and be more efficient. We must also invest massively in research in a concerted manner.
Finally, this crisis exposed the flaws in the national health systems. We must think about the means to guarantee funding for public health commensurate with the challenges posed. The budgetary restraint imposed by the Maastricht rules must no longer be a straightjacket.
Leaving to explode deficits and debts?
E.L.: Member States will see their public debt increase by 10 to 20% of GDP. It will be a headache for some. That is why it is essential that the Union be flexible in applying the rules of the Stability Pact. Particularly when it comes to investments in health which must be set aside from budgetary discipline and secured, in a way.
Should the Union have a more ambitious budget, with common resources to finance common needs?
E.L.: For the moment, the agreement on a 2021-2027 budget remains blocked by some northern countries which wish to reduce public spending and national contributions. But this position is not sustainable over time.
The crisis has brought back the old North-South and East-West divides which threaten to cut Europe into pieces. Everyone will come to understand that more European investment is needed, as President Macron has proposed. In this regard, the renewed alliance between France and Italy is decisive.
Can we hope, in the long term, for a “European Health Pact” as there is a “Green Pact” for climate transition?
E.L.: In any case, this is the perfect time to do it. In the area of climate transition, the new commission has managed to create a consensus, set ambitious targets, and acquire new financial instruments. President Ursula von der Leyen, a doctor by profession and a former German health minister, must do the same to ensure the health protection of European citizens.
Jacques Delors considered that, in the absence of a common vision, the Union was in mortal danger. Do you share this fear?
E.L.: Totally. Europe is living in a historic moment. The crisis brings us back to the idea that the Union was built on solidarity and that without it there is no Union. The epidemic affecting our countries should remind us that no one can save himself.