The promise of revolutionary advances in healthcare is now a mainstay of the EU’s artificial intelligence strategy. Jason Tucker explores how the outcomes of the EU’s instrumentalisation of healthcare in the AI race doesn't look good for waning EU political legitimacy
In the European Commission’s recent AI First policy, the potential of regional investments in artificial intelligence (AI) to improve healthcare features very prominently. More broadly, as a means to secure public and political buy-in, the EU has instrumentalised healthcare as a standard bearer for its AI policy.
The outlook for the future of public health in the EU is bleak. Healthcare systems have been weakened by underfunding, worker shortages, and profound demographic and public health shifts. The result is significant health disparities within member states and across the region. In this context, the promise of meeting systemic challenges and improving public health has great appeal.
The EU has linked its AI policy ambitions closely to the healthcare sector. But in so doing, it risks further undermining its already shaky democratic legitimacy. Regardless of the outcome, the prognosis is troubling. If the initiative fails, the EU may be scapegoated by member states who are unable to deliver adequate healthcare. If it succeeds, EU healthcare systems could become an even more prominent target in the escalating geopolitical contest for AI supremacy.
Often overlooked, healthcare plays a fundamental role in shaping democratic legitimacy and the relationship between citizens and the state. And unlike many other areas of government activity, healthcare is universally relevant. We all need healthcare throughout our lives, whether we choose to access it or not.
The EU claims that AI won't simply save healthcare systems, but will address the root causes of public health challenges
Public healthcare systems are a primary point of interaction between individuals and the state. When these systems are inadequate or inaccessible, this significantly erodes public trust in states. Similarly, poor management of public health can diminish political legitimacy at national and regional levels.
So far, the EU has largely avoided denouncing Europe’s ailing healthcare system for fear of igniting a political powder keg. But a new EU narrative, championing AI as key to tackling the challenges faced by crumbling systems, could change that.
The EU’s recent industrial policy on AI promises high-speed transformative developments. One justification for this policy is the improvements that AI advances promise for healthcare services. The EU claims that AI won't simply save healthcare systems, but will address the root causes of public health challenges as well as providing personalised healthcare.
The reality is far from this. AI in healthcare can improve some areas of health, for some people, but always at the expense of others. Indeed, unless carefully controlled, states have little say over how such technology benefits society, because it exists largely in private-sector hands. Market interests and those of public health don't naturally align.
States have little control over how AI advances benefit healthcare, because such technology exists largely in private-sector hands
Research also shows poor returns on our investments. Implementing AI in clinical settings faces myriad challenges, and the hype around certain AI models is pulling scarce resources away from well-functioning approaches. The World Health Organization has warned that the (albeit limited) positive impacts of AI in healthcare can only be realised if there is a broad, well-funded public healthcare system to support its adoption. Innovation is all well and good, but adoption is a major sticking point.
Given the rhetoric of the high-speed transformation surrounding AI’s potential, its failure to improve the everyday healthcare experiences of EU citizens won't go unnoticed for long. People care deeply about healthcare. Waiting times, access to services, and quality of care matter. If AI is not shown to be delivering tangible healthcare benefits, and quickly, the EU risks have an increasingly disgruntled, and increasingly unhealthy, population. This is bad news for the EU's political legitimacy, and could further fuel the rising Euroscepticism sustained by the EU’s top-down policies. The EU will quickly become a useful scapegoat for the failure of AI to bolster Europe's ailing healthcare systems.
On the other hand, if the EU succeeds in delivering noticeable improvements in healthcare using AI, new challenges emerge. Healthcare is already a prime target for cyberattacks in the EU (and globally), more so than any other critical sector. As Marietje Schaake argues, the EU’s digital exceptionalism frames digital-realm attacks as an acceptable part of a geopolitical tech struggle, despite its devastating real-world impacts on the health of EU citizens.
Healthcare, however, is gaining increasing prominence as a barometer for the EU’s place in the AI race. The success of its AI industrial policy will therefore further focus geopolitical crosshairs on the sector. The EU's fragmented approach to AI adoption makes it vulnerable to attack. And the region’s weak digital sovereignty means that digital healthcare systems are relatively easy pickings for nefarious actors looking to disrupt the EU’s AI ambitions. There is also the potential of weaponised interdependence if the EU appears to threaten US interests on AI. This is worrying, because the EU healthcare sector is deeply reliant on US Big Tech for its digital infrastructure.
Cyberattacks on the health sector don't merely threaten healthcare, they destabilise international security
The WHO has argued that cyberattacks on the health sector don't merely threaten healthcare, but destabilise international security. If the EU makes substantial progress on AI in healthcare, this creates increasing economic and political incentive to disrupt it. Such progress also increases the demand for the EU to react accordingly, to protect its interest and maintain its political legitimacy as a security actor. The limits of the EU's digital exceptionalism may thus be shrinking.
By putting healthcare at the heart of its AI strategy, the EU is taking a high-stakes gamble. It has positioned AI as both a solution to systemic public health challenges and a symbol of geopolitical relevance.
But while the appeal of using AI to revolutionise healthcare is powerful, the reality is far more constrained. Failure to deliver tangible improvements risks eroding public trust – not only in healthcare systems, but in the EU’s broader democratic and security agendas. Moreover, linking AI so closely to healthcare increases the sector’s exposure to geopolitical threats and cyberattacks. Win or lose, the EU may find itself either weakening its democratic legitimacy or putting Europeans' healthcare at the frontline of a geopolitical battle for which the region is ill prepared.
