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The enlargement of Europe has forced countries to reevaluate every aspect of their government – including the precious welfare state. How can a country such as Belgium benefit from enlargement? Is the new outlook on Europe a force for good? Are the benefits of outsourcing greater than the social costs involved?

We looked at the fundamental nature of the social reform agenda in an enlarged Europe: Is France’s policy approach a beacon to be followed? Or do the new member states know better? What path would most benefit Belgium?

Following an introduction by the former President of the European Parliament, Mr. Pat Cox, four panelists representing "old" and "new" Europe debated their visions of social reform.

In the coming years, biotechnology will enable us to identify, understand, manipulate, improve and control living organisms (including ourselves). Better disease control, custom drugs, gene therapy, age mitigation and reversal, memory drugs, prosthetics, bionic implants, animal transplants and many other advances may continue to increase the human life span and improve quality of life. It is quite possible that these new technologies will radically transform public health and healthcare for those who cannot now afford such care, while also enabling unprecedented levels of care for those who can. But what will be the impact of this impending technological revolution on the provision of healthcare? Will the current model of health care insurance be able to cope?

Can the EU digest a largely Muslim, if officially secular, country? Will Europeans be happy at the prospect of Turkey becoming the biggest country by population, thus having the most votes and most seats in the European Parliament? Is the EU strong enough to absorb a country so much poorer than the rest of its 25 members? How far will Turkey's human rights record come into account? Is it a good idea for the EU to extend its borders to Iran, Iraq and Syria? And how can the problem of
Cyprus be resolved?

Upon joining the EU, Central and Eastern European countries attempted to replicate the Western welfare model, but very soon found they could not sustain such a costly system. The impending crisis that the Western model would wreak on the new EU member states forced them to devise new models of spending and taxation.

Some countries, like Slovakia, have already implemented major reforms in areas such as healthcare, tax and social security with great success. Others, such as the Czech Republic are devising new and interesting proposals for successful healthcare systems and a more efficient welfare model.

Pavel Hrobon will join us to discuss the nature of the Eastern reforms and the prospect of these new proposals being implemented in ‘old’ Europe. Pavel is the co founder and chairman of the health think tank healthreform.cz, an organization whose aim is to prepare and support the implementation of a substantial overhaul of the Czech health care system.

The author warns of the dangers of excessive choice. ‘Choice overload’, he says, can make you question decisions before you even make them, it can set you up for unrealistically high expectations, and it can make you blame yourself for any and all failures. In the long run, this can lead to decision-making paralysis, anxiety, and perpetual stress. Should we be striving for a culture that tells us that there is no excuse for falling short of perfection when your options are limitless? In The Paradox of Choice, Schwartz explains why and at what point he believes choice - the hallmark of individual freedom and self-determination that we so cherish - becomes detrimental to our psychological and emotional well-being. Is Schwartz right? Is too much choice a bad thing – and what does his argument, which has been much debated by the UK commentariat, have to teach us about the politics of the choice debate in public services?

Which party can best manage the market? It used to be a straight choice: Thatcherite Tories wanting to unleash the profit motive, and Old Labour chiefly concerned with social justice and equity. New Labour seemed to square that circle, but can their hybrid (some say fudged) approach continue credibly? Can the Conservatives win over an electorate sceptical of purely market-based solutions? And will the economic liberalism of the ‘Orange book’ become the Lib Dems’ official party line? As the election looms, each party must now convince voters that they best understand both the workings of the market and its wider impact on society.

The European social model is struggling to survive in the age of globalisation. Healthcare systems that siphon huge sums of money from the taxpayer are paying few dividends; pension systems that rely heavily on state subsidisation cannot cope with the ageing population, and government taxation to pay for the vast array of social services is failing to deliver. These are the views of Johnny Munkhammar.

Mark Leonard, whose recent book ‘Why Europe will run the 21st Century’ stands in stark contrast to Munkhammar’s vision. Leonard views Europe as a ‘revolutionary model for the future’ and states unambiguously that those who believe Europe to be weak and ineffectual are wrong.

The two battled it out at this event at the Hotel Amigo.

This book is a substantial development of, and addition to insights provided by the likes of Hayek as to why decentralized decision-making by large numbers of people is very often superior to the decisions and opinions of ‘experts’, whether in government, companies or financial markets. The discussion provides an opportunity to discuss and apply Suroiwiecki’s insights in a specifically British context and what this might mean for democratic institutions and the public sector.

Nine months after accession, the Stockholm Network and the Centre for the New Europe are co-hosting a major full-day conference entitled 'Does the West Know Best?' to examine whether the EU-15 can learn from some of the new member states’ more radical approaches to social and economic reform, such as flat taxation, the privatisation of social security and moves towards more market-oriented health systems.

Governments all over the Western world are struggling to curb or control healthcare spending. More often than not, reform tends to concentrate on macroeconomic levers to reduce expenditure and occasionally takes forms which amount to downright rationing of health services.

Experience shows that opening the health market to choice will increase spending. The political challenge is how to take advantage of this growth potential.

Laurent Alexandre (MD) is a French health economist with a unique inside experience of the health care system, both as a surgeon and senior civil servant. He is the founding president and CEO of Medcost, a leading consultancy specializing in online management of health services.