On 24 April, the European Parliament has passed a landmark Directive which would allow Europeans seek healthcare abroad more easily and be reimbursed for the cost of doing so. However, EU member states are still working to iron out a range of practical difficulties before the plan can be formally adopted in the Council.
After a heated debate on the law, which has polarised the parliament into a broadly pro-law right and anti-law left, the plenary eventually passed the first reading with 297 MEPs to 120 backing the proposal, and 152 abstentions.
According to Euractiv.com, CPME, the standing group of European doctors, congratulated the European Parliament on passing the proposal for a Directive at first reading. "CPME welcomes the European Parliament's call for clearer rules on EU citizens' access to treatment elsewhere in the EU. The vote on this report is the first step in the right direction for establishing a level playing field in cross-border healthcare," the committee said in a statement.
Under the proposal, patients gain the right to be reimbursed up to the level they would have received under the system in their home country. Member states can also choose to cover other related costs, such as therapeutic treatment, accommodation and travel expenses.
Patients may have to request permission from the their local authority first, in order to preserve the financial stability of member states' social security systems. A European health ombudsman would be set up to take care of patients' complaints arising from the law.
EUObserver.com quoted outgoing Liberal Dutch MEP Jules Maaten saying: "Today's vote is a victory for all Europeans who are suffering from rare diseases and other serious illnesses. They will be able to receive medical care abroad without having to worry about costs, safety and quality."
Policy Summary
Health systems are currently primarily the responsibility of the member states. In some cases, however, EU citizens may seek health care in other member states, with the cost covered by their own health systems. This has been confirmed by several European Court of Justice (ECJ) rulings since 1998 (i.e. Kohll and Decker, Smits and Peerbooms, Vanbraekel, Müller-Fauré/van Riet, Inizan and Watts),
In June 2002, the Council agreed that there was a need to strengthen co-operation on patient mobility to promote access to high-quality health care "while maintaining the financial sustainability of healthcare systems". Following Council's invitation, the Commission convened, in 2003, a 'High-Level Process of Reflection on Patient Mobility and Healthcare Developments in the EU '. This reflection group produced, in December 2003, a set of recommendations representing a political milestone by recognising the potential value of European cooperation in helping Member States to achieve their health objectives, which were largely taken into account in the Commission's April 2004 Communication on patient mobility.
A stakeholder consultation on establishing an EU framework on healthcare services was organised in autumn 2006 (see summary report of responses).
Issues:
After repeated delays and lengthy consultations, the proposal for a Directive on the application of patients' rights in cross-border healthcare was finally published on 2 July 2008.
The overal goal of the directive is to clarify the right of patients to seek health care in another EU country while being reimbursed by their national system.
The stated aims of the proposal are three-fold:
- To help patients exercise their rights to access cross-border care;
- To give people assurances about safety and quality of cross border care, and;
- To help national health systems cooperate to achieve economies of scale.
The proposal, once adopted, would give EU citizens the right to seek non-hospital care, such as dental care, visits to the optician or medical consultations, in another member state without prior authorisation. The patient would need to pay for the care first and then seek reimbursement from his statutory national system. The reimbursement will be made for costs of care which, had they been provided on national territory, would have been paid for by the social security system.
As for hospital care, which the Commission defines as requiring at least one night of hospitalisation, member states may put in place a system of prior authorisation for reimbursement in two cases. First, if the care could have been provided and reimbursed in the home country and second, if the outflow of patients is such that it puts in risk either the finances of the national social security systems or the planning of hospital capacity.
The draft directive requires EU member states to set up national contact points for cross-border healthcare and provide citizens with information on their right to seek care abroad. It also states that non-nationals enjoy the same rights regarding access to care as nationals and thus prohibits any discrimination based on nationality or indeed any other grounds.
The proposal aims to enhance cooperation between EU-27 national health system by introducing mutual recognition of prescriptions issued in another member state and the establishment of European reference networks of care providers in order to allow access to specialised care for all and develop economies of scale. Member states are also expected to enhance cooperation on eHealth by adopting measures to make healthcare ICT systems interoperable and share their efforts regarding the management of new health technologies, including health technology assessment (HTA).
Conclusion
EU legislation directly affects the every day life of European citizens, professionals and businesses. It is estimated that between 60% and 80% of the legislation in force in Europe originates in Brussels. To learn more about the key role associations can play as stakeholders in the decision making process, click here.
Sources: Euractive, EUObserver, European Voice, European Commission
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