The worst sticking points regarding the draft directive on cross-border health care were resolved in the Committee for Environment, Public Health and Food Safety. Only two members voted 'no' and one abstained.
The proposal could be adopted by the full Parliament next June.
"You can feel there is a lot of reticence" on some issues, said Françoise Grossetête, a French member of Parliament and the rapporteur on the proposed directive for the centre-right European People's Party (EPP).
But the committee is "unified," she said, touching the edge of a wooden table for luck.
The new rules would especially help retirees living abroad, people with rare diseases and those living near borders to get the best health care. Currently, only about 1%, or €10 billion, of public health budgets are spent on cross-border health care yearly, although that figure could rise with standardised rules for authorisation and reimbursement.
There were 227 amendments to the plan, and six consolidated amendments, but the handshakes 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 could only refuse to authorise cross-border care in a very limited number of circumstances.
- The 25 million Europeans with rare diseases would be covered under the proposed law.
National health systems nervous
Still, plenty of people are nervous. National health systems operate very differently from country to country, and some health officials are concerned about managing their finances and demand for hospital beds.
Hannele Häkkinen is one of them. Speaking for the Association of Finnish Local and Regional Authorities, she said "if foreign people are coming for services in our country, you still have to organise services for the population in your country. Somehow you have to manage these patient flows".
Normally, however, data show that people prefer to stay close to home and family when in need of medical care. They usually only travel afar 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, according to Daniel Mart, a general practitioner in Luxembourg city and a member of the Standing Committee for European Doctors.
Most countries spend 1% or less of their national health budgets on cross-border care, and "the real menace would be the hospital stays, operations and highly specialised care given outside the border," Mart explains. "If you have 3% of care outside your borders, you get distortions in the system."
While Luxembourg has adapted, some countries are reluctant. Poland, Slovakia and Portugal voted against the proposal in Council last month, and Romania abstained.
Nevertheless, the proposal now has broad support in the Parliament, and consumer advocates are in favour.
"We've made good progress," said Grossetête, the Parliament rapporteur.