Cross border care

Rita Baeten, Policy Analyst at Observatoire Social Européen, questioned at the 5th Annual World Health Care Congress Europe 2009 if the proposed Directive for patient rights at cross border care really is about patients rights. One of her key objections was that the aimed legal certainty isn’t achived. I can see the problems this creates but I actually want the directive mostly for the new rights it aims to give patients! It do not only codyfy current case law. It also somewhat liberalize the demand for prior authorization and allows patients to go abroad not only for same care offered in the home country but also for similar care. Key for those seeking methods not used in the home country for example for rare diseases.

Rita Baeten also raised concerns that the proposed directive will lead to new actors entering the publicly funded systems. I can only welcome that development. Interesting was also her point that according to the European Court of Justice health care provision is an economic activity and claimed that when it comes to the provider side almost any regulation is a potential non allowed restriction. She underlined her point with the following list of cases:

- Opticians only 1 shop: not proportional (ECJ 2005)

- Quota system for psycho-therapists based on established rights: necessity not proved (ECJ 2007)

- Prohibition on television publicity for aesthetical surgery: not justified (ECJ 2008)

- Authorization to set up a private outpatient clinic: not justified (ECJ 2008)

As mentioned in an earlier blog post infringement procedures have been started in several member states with regards to variations of restriction around establishing pharmacies. All together it makes me contemplate how the healthcare systems in Europe will be organized in a couple of years if companies and the EU commission will continue to push cases through ECJ.