A Commission proposal published yesterday (2 July) to make it easier for citizens to seek care abroad could see its effectiveness limited after new clauses were introduced. These would allow member states to require patients to get prior authorisation for foreign hospital care and pay upfront themselves.
After repeated delays and lengthy internal consultations, the Commission finally published its proposal for a Directive on the application of patients’ rights in cross-border healthcare on 2 July 2008.
Overall, the directive is set to clarify the right of patients to seek health care in another EU country while being reimbursed by their national system.
The stated aims of the proposal are three-fold:
- To help patients exercise their rights to access cross-border care;
- to give people assurances about safety and quality of cross border care, and;
- to help national health systems cooperate to achieve economies of scale.
The proposal, once adopted, would give EU citizens the right to seek non-hospital care, such as dental care, visits to the optician or medical consultations, in another member state without prior authorisation. The patient would need to pay for the care first and then seek reimbursement from his statutory national system. The reimbursement will be made for costs of care which, had they been provided on national territory, would have been paid for by the social security system.
As for hospital care, which according to the Commission is defined as requiring at least one night of hospitalisation, member states may put in place a system of prior authorisation for reimbursement in two cases. First, if the care could have been provided and reimbursed in the home country and second, if the outflow of patients is such that it puts in risk either the finances of the national social security systems or the planning of hospital capacity.
In early drafts of the proposal, patients did not need prior authorisation from their national systems either for hospital or non-hospital care. However, the Commission felt that such a proposal would not gather enough support from the European Parliament or the Council to be finally adopted.
The draft directive asks member states to establish national contact points for cross-border healthcare and provide citizens with information on their right to seek care abroad. It also states that non-nationals enjoy the same rights regarding access to care as nationals and thus prohibits any discrimination based on nationality or indeed any other grounds.
Regarding the enhancement of cooperation between EU-27 national health systems, the draft proposes mutual recognition of prescriptions issued in another member state and the establishment of European reference networks of care providers in order to allow access to specialised care for all and develop economies of scale. Member states are also expected to enhance cooperation on eHealth by adopting measures to make healthcare ICT systems interoperable and share their efforts regarding the management of new health technologies, including health technology assessment (HTA).