1st Dec 2021

EU executive to tackle patient mobility in new social package

  • Brussels is to take up again the controversial issue of patients' mobility across the EU (Photo:

The European Commission is due to unveil a bill specifying conditions under which patients can seek health care in other EU member countries on Wednesday (2 July).

The proposal comes after a huge opposition from MEPs and some national capitals to Brussels' previous attempt to tackle the issue last December, and the commission signalling earlier this year it would not revisit the topic during its current mandate, set to expire in autumn 2009.

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But after a switch in personnel in the post of EU health commissioner, the new Cypriot delegate, Androula Vassiliou, decided to give it a try and address opponents' concerns in a new approach towards the controversial subject.

Previously, the EU executive hewed close to several verdicts by the European Court of Justice, stating that the bloc's general principle of freedom to receive and provide services should apply equally to the health sector, while recognising "the specific character of these services."

But while Brussels still refers to the Luxembourg court's statements in its new blueprint, it is exclusively focusing on patients' rights to obtain treatment abroad and have it reimbursed, without touching the issue of free movement of health care providers and their competition across the continent.

In addition, Brussels has introduced more possibilities for member states to restrict the practice of patients seeking health care abroad, which is usually the case for people living in cross-border regions, or those facing long waiting-lists or lack of medical expertise and equipment in their home countries.

Currently, cross-border care costs take up around one percent or €10 billion of total public health care expenditure per year which amounts annually to €1,000 billion across the EU, according to a commission official.

Under the draft legislative proposal, citizens would have to receive reimbursement for their health treatment abroad up to a certain level and for the kind of treatment for which they would be reimbursed if treated at home.

But in the case of hospital care or very expensive types of treatment - such as those involving special equipment - member states could introduce a prior authorisation scheme to restrict patients' mobility if they had evidence suggesting that without such measures, their national health budget would come under pressure.

In a bid to assist poorer citizens who could not afford to pay for health care abroad upfront with reimbursement coming later, governments could also set up national regimes providing payments in advance for some treatment abroad.

Social aspects

Despite the changes in the content of the patients' mobility bill and the tactical move to present the dossier as part of the commission's social agenda, not all members of the 27-strong college are due to support it on Wednesday, according to sources close to the discussion.

EU economy commissioner, Spaniard Joaquin Almunia, has maintained a "fundamental objection" against the proposal ahead of today's meeting, due to concerns that the EU rules would allow patients to receive private treatment abroad that would not be possible in their home country.

Apart from the bill on cross-border health care, the EU executive is due to present a series of other initiatives under a "renewed social agenda," just two days after the French president, Nicolas Sarkozy, kicked off his country's EU presidency by saying that Europe should do more to protect its citizens.

The commission's package deals with controversial verdicts by the EU's top court that have restricted the right of unions to protest against companies employing foreign workers under inferior conditions than those required by law in the host country.

It also tackles the EU's global adjustment fund - agreed in 2005 mainly due to French pressure as a way to compensate workers affected by globalisation - and raises the possibility of making easier the eligibility criteria for countries to apply for financial aid from the fund.

Finally, among other non-legislative documents in the package, Brussels is to put forward a new anti-discrimination bill excluding unfair treatment on the basis of gender, sexual orientation, religion or age in social protection and in access to and supply of goods and services.

The social package is due to be discussed by social policy ministers already next week at an informal meeting in Chantilly (10 - 11 July).

Power to the patient

Doctors, it is said, are not what can be called early adopters of new technologies. Any healthcare revolution, then, will have to come through patients. Or rather, consumers, because patients of the 21st century make their own decisions.

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