European Parliament MEPs have voted on new EU rules on access and rights to cross-border healthcare. The vote strikes a balance between guaranteeing patients' rights to cross-border healthcare and safeguarding the provision of quality health services at national level. Patients have the right to get hospital treatment in other member states and be reimbursed as they would for receiving the treatment at home, however this right should not be at the expense of the viability of national health systems.
The proposal will allow member states to establish a reasonable system of prior authorisation for treatment, but MEPs succeeded in significantly narrowing the list of reasons for which a patient can be refused cross-border treatment. An important change from earlier drafts is that member states will not be able to refuse reimbursement after prior authorisation has been granted. MEP’s hope that The European Council will take these improvements on board, so that the legislation can be finalised as soon as possible.
At present if a European citizen wants to get treatment in another country they do not know if they will be refunded and how that may happen. There have been difficulties that citizens have brought before the European Court of Justice. So the European Parliament must legislate to solve this problem. This directive is designed to allow patient mobility. We already have mobility of workers and students. It is part of the fundamental rights of European citizens. This does not encourage medical tourism, but simply to allow a wider range of public health for patients, especially in border regions.
If the directive is approved, patients will have a choice about the place where they seek treatment and the possibility of having the best possible care. There will be centres with national contacts to access information relating to health care in other countries.
* 1% of public health budgets spent per year on cross-border healthcare.
* 30% of EU citizens are not aware of the possibility to receive healthcare outside their country.
* 25 millions of European citizens suffer from rare diseases.
If someone needs permission to go and receive care in another EU country, the payment will be paid directly by the country of the patient to the country where the medical care is received. Many EU countries have resisted this proposal, as they fear an invasion of patients and an increase in healthcare costs. While most now accept the outcome as inevitable, some countries are reluctant. Poland, Slovakia and Portugal voted against the proposal in Council last month, and Romania abstained.
Cross-border medical care is only a very small portion of public spending on health. In most cases patients can be reimbursed for treatment in another country only if this treatment is covered by their national system, and the level covered in their state. For example, if in Germany patients are not entitled to dental care reimbursement and they go for treatment in France, Germany will not have to repay them. There will be no way for a patient to obtain a financial benefit related to reimbursement.
There were 227 amendments to the plan, and six consolidated amendments, but verbal agreements were made over the following three points:
* Patients can seek medical care in another country without prior authorisation. However, for hospital stays and specialised care, patients could need pre-authorisation from their national health system.
* A country can only refuse to authorise cross-border care in a very limited number of circumstances.
* The 25 million Europeans with rare diseases will be covered under the proposed law.
Normally, people prefer to stay close to home and family when in need of medical care. They usually only travel far when they need specialised treatment, or when better facilities are just across the border. This is frequently the case in Luxembourg, where a lot of residents go to neighbouring France, Belgium or Germany for treatment. About 7% of the country's medical payments are cross-border, the highest in the EU. Most countries spend 1% or less of their national health budgets on cross-border care.
The proposal now has broad support in the Parliament, and consumer advocates are in favour. European consumer organisation BEUC supports the European Parliament's position, and says, ''Patients do not like to be cared for far from home in another member state, but if they want or need to they should be entitled to the same rights for information, treatment and reimbursement".
July 2008: European Commission proposal
April 2009: European Parliament first reading
June 2010: Council's of EU ministers reach their position
October 2010: Report scheduled for adoption in EP committee, 2nd reading
January 2011: EP plenary sitting, 2nd reading
June 2011: Adoption of the directive