Wednesday 20 May 2009

Cross border care - Techniker Krankenkasse survey

The Patient Directive for Cross Border Care was voted upon in the European Parliament in April but it doesn’t mean it’s a done deal. It is now in the hands of the European Council and the negotiations are said to not go to well. Most likely we will have to continue the fight for this one, in the capitals to convince the member states, call or mail your Ministry of Health with your view on this, and in the European Parliament to convince the new MEPs at the second reading in the EP.

I found some statistics that might be useful in the discussions: Techniker Krankenkasse in Germany (2n largest statutory health insurance fund) have done an analysis of cross border care by looking into the statistics around the 34000 of their members who did ask for reimbursement in 2007 having used medical services in other EU countries. When taken their figure on members that experienced cross border care 2007 and extrapolate it to all Germans this must mean that 680000 people in Germany received care cross border in the EU. It’s an issue concerning a lot of the European citizens!

40% of those served by the TK having received planned care – the rest acute care. The most popular countries to be treated in where Spain then Austria and Italy, the Czech Republic, Poland, France, Switzerland and Hungary.

The reasons given didn’t differ much from the results in the Eurobarometer 2008 and the Health Consumer Powerhouse survey from 2006 on the same topic. But the no 1 was a surprise for me – admittedly the need for better quality care in other countries might be less of a driver to seek care across the border if you live in Germany compared to some other EU countries…

Greater comfort in treatment 14%, Savings on services for which co-pay­ments are required in Germany 13%, New treatment methods 7%, Treatments not acknowledged in Germany 7%, Facilities with which TK has signed contracts 6%, European specialists, 5%, Doctor of trust based in another EU country 5 %, Special clinics in border regions 3%, Other reason 40%.

Interesting is also that only 5% of those with real experience of healthcare cross border where less satisfied or unsatisfied. It’s when it comes to the billing the problems start. Looking into detail of why there are not satisfied the high additional costs, 30%, were the main reason while low quality where 21 and language problems 18%.

Two other area you often hear a lot about the need of improvement, also from me, seems to be areas that actually are less of an issue at least if you believe this survey: Information deficits on the part of doctors or hospitals 6No follow-up treatment 5, No guarantee claims 4. Multiple answers where possible. Since direct private billing allows higher prices there is no financial incentive for the care providers to ac­cept the EHIC. I.e. EHIC is not accepted by all care providers. So 41 percent of the TK members surveyed stated that they had tried to pay for the treatment with the EHIC but failed. Jet another reason for transparent pricing of healthcare services! That member states are fighting this I really cannot understand.

Find the full survey here

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