The bill now goes back to the European Parliament, which has already backed a more far-reaching version of the directive. A majority of MEPs will have to vote in favour of a revised text before it can become law.
European governments have accepted a compromise that will see patients reimbursed for medical treatment in other EU member states, but are insisting on a series of safeguards giving health authorities the power to prevent patients from travelling under certain circumstances (EurActiv 08/06/10).
There was also greater clarity on who should pay for treating pensioners who take up residence in another member state during their retirement – a complex issue that required detailed behind-the-scenes negotiations ahead of the ministerial meeting.
For example, in most instances, the agreement says a French pensioner living in Spain will be reimbursed by the Spanish state if they seek treatment in Germany. But France would pick up the tab if that pensioner were to be treated in France.
Parliament wants more equity in final text
A final deal must be agreed between MEPs and governments before the new rules are transposed into national law.
However, the Parliament has taken a more liberal view of how far the directive should go in facilitating patient mobility, and some MEPs feel the European Council's compromise attaches too many conditions to patients' rights.
French centre-right MEP Françoise Grossetête (European People's Party), who is rapporteur on the directive in the European Parliament, described some of the commitments as "fragile" and said the final text should be more equitable.
Patient advocates also harbour concerns that citizens will have to pay for treatment upfront and seek reimbursement later under the rules.
Some of the language of the final text should be clarified in order to avoid variations in how member states apply the law, according to some stakeholders. However, diplomatic sources say a degree of "constructive ambiguity" is necessary in order to move the dossier forward.
There was a broadly positive view of ministers' agreement to push ahead with closer cooperation on cross-border e-health, although the final wording of the text stressed the fact that rolling out new health technology is a matter of national competence.
MEPs will debate the issue again before the end of the year, but sources suggest it is too early to declare the issue closed given the differences between the Parliament and member states.
The Belgian Presidency is expected to begin negotiations with MEPs with a view to wrapping up a final agreement before Belgium hands over the rotating EU presidency to Hungary in 2011.
