Brussels postpones landmark bill on EU cross-border health care until 2008
The European Commission has postponed the unveiling of a landmark legislative proposal tackling patients' rights to receive medical treatment in another EU member state until early in 2008 due to a series of open and controversial questions that need further discussion.
The blueprint on "application of patients rights in cross border healthcare", which was supposed to be adopted on Wednesday (19 December), sets out clear rules on who is responsible for covering the costs and secure quality of medical treatment of Europeans provided in a member state other than their own.
Join EUobserver today
Get the EU news that really matters
Instant access to all articles — and 20 years of archives. 14-day free trial.
Choose your plan
... or subscribe as a group
Already a member?
It follows several verdicts by the European Court of Justice stating that the bloc's general principle of freedom to receive and provide services should equally apply to the health sector, while recognizing "the specific character of these services."
"The uncertainty about the general application of rights to reimbursement for healthcare provided in other member states is creating obstacles to the free movement of patients and of health services more generally in practise," reads the draft document, seen by EUobserver.
The commission wants to remove such obstacles and at the same time ensure that "the impact of cross-border healthcare under this proposal does not undermine health and social security systems, either through its direct financial impact or through its impact on overall planning and management of those systems."
Apart from introducing common legal definitions in the health care area, Brussels' plan centres around three key principles.
Firstly, it is up to the member state providing medical treatment to secure and monitor its quality and safety standards for all patients.
Secondly, the home country of a patient should cover the costs of healthcare provided in another EU state, up to a certain level.
And finally, all national authorities are required to set up "national contact points for [providing information to patients on] cross-border healthcare," with their form and numbers to be decided by individual member states.
Under the proposal, these provisions would apply to all types of health services, with the commission stressing that "neither the special nature nor the way in which they are organised or financed removes them from the ambit of the fundamental principle of freedom of movement."
What should be reimbursed?
In a bid to avoid "undermining a social security system's financial balance" with its legislative blueprint, Brussels distinguishes between the conditions for reimbursement of the costs for hospital care and non-hospital treatment provided to patients in other EU states.
In case of health treatment not requiring a patient to stay in hospital at least for one night, member states will not be allowed to set out any conditions for their citizens to seek treatment abroad and be reimbursed for it.
On the other hand, the commission suggests that national governments should be allowed to introduce "a system of prior authorisation" for "limited cases" requiring hospital treatment of patients outside their home country, if they can justify it by proving there would be "sufficient distortions" to their national healthcare and social security system.
But even before its introduction, Brussels has been accused of favouring the rich against the poor in the health bill.
European Social NGOs accused the author of the proposal, health commissioner Markos Kyprianou, of a "lack of solidarity" for his suggestion that while patients would be reimbursed for treatment abroad to the same level as if treated at home, they would still have to cover their travel and other expenses.
"Why does the EU directive not take account of other issues which are in the general interest of everyone living in the EU, such as equal access to affordable high quality health services for all, including particularly vulnerable groups," said Social Platform president Fintan Farrel.
"That would show that the commission understands the concept of collective solidarity, not only individual consumers' rights," he added.
The bill has been postponed until early January as several questions are expected to prompt further debate between commissioners, including on how and when patients who opt for treatment abroad should be reimbursed.