Patients in the EU currently are able to go to another Member State to seek treatment, under two different EU frameworks – Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare and Regulation No 883/2004 on the coordination of social security systems. However, after a decade since the implementation of the Cross-Border Healthcare Directive, these rules are unfortunately still not used enough. The problem is that very few individuals within the EU are aware of their entitlement to seek medical treatment in a different country, only a minority of patients and not all healthcare professionals are aware of the right of patients to seek cross-border healthcare under the two existing frameworks.
Also, the procedure is very complicated and takes a long time. Patients need to pay up-front for treatment and seek reimbursement back home afterwards, when they use their rights prescribed in the Directive. Furthermore, it is necessary to reduce logistic and linguistic barriers faced by patients when accessing healthcare in another Member State and provide patients with clear information on prior authorisation requirements that apply to the certain Member States. Delivering updated, certified and transparent information to citizens and professionals is crucial. Also, there is a need for development of Commission guidelines setting acceptable and harmonised review and approval timelines to expedite time-to-treatment in the EU under the Social Security Regulation. I strongly advocate for the increase in the number of information campaigns regarding patients’ rights to access cross-border healthcare, targeting both the general public and healthcare professionals.
We must ensure that patients have the right to request a second opinion from specialists in other Member States
Crucially, we should move authorisation rules that are currently in the Cross-Border Healthcare Directive into the Social Security Regulation. This transition would simplify reimbursement processes for patients, establishing a more transparent and legally sound framework. Hence, it is important to revise both the Cross-Border Healthcare Directive and Social Security Regulation. However, the latter is currently stuck in trilogues between Parliament and Council. More than seven years after the Commission presented revision of existing framework, the file has seen 18 trilogues, 12 rotating EU presidencies and two provisional agreements without a positive outcome in the end. The main problem is that compromise cannot be reached between Member States, especially relating to the rules on unemployment benefits, particularly for cross-border workers and the rules on applicable legislation. We need a stronger political will to change the current status quo, but also to revise Regulation in regards to cross-border healthcare rules.
Moreover, it's essential to ensure that all treatment-related costs are covered upfront to minimise the exclusion of low-income patients. In order to achieve this, in the context of the next revision of the existing frameworks, Commission should consider setting up of a single set of authorisation and reimbursement rules for access to cross-border healthcare, including a right to a second opinion. Currently, when it is determined whether patients should get sufficient treatment in their country or they should seek a treatment in some other Member State, domestic specialists have a crucial role in making these decisions and it is plausible that they may prefer choice of domestic treatment. Therefore, we must ensure that patients have the right to request a second opinion from specialists in other Member States. Given these compelling reasons, I urge the next Commission to take a bold step forward and initiate the revision of cross-border healthcare rules.