The incoming Hungarian EU Presidency will try to encourage healthcare "tourism" in Europe as the EU tries to push through new legislation to facilitate cross-border treatment.
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BACKGROUND
In October 2010, the health committee in the European Parliament approved the directive on cross-border health care, paving the way for its adoption early next year. The member states should give the final nod in March.
The directive has been discussed since 2008, when the Commission proposed a draft text aimed at providing EU citizens with legal certainty on their medical rights in other member states.
Health systems are primarily the responsibility of the member states, but EU citizens may rightfully seek health care in the other countries – with the cost covered by their own system – as confirmed by several European Court of Justice (ECJ) rulings since 1998.
This can occur in instances where better health care is provided in another member state, for example in rare conditions or specialised treatment. It may also be the case in border regions, where the nearest appropriate facility may be situated in another country.
However, health services remained excluded from the Services Directive in spring 2006 (the so-called 'Bolkestein Directive'), despite the many ECJ rulings showing that they to be considered an economic activity and that Community law applies to them.
The directive on cross-border health care is aimed at clearing up this legislative ambiguity.
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After an overwhelmingly positive vote by its health committee in October, the European Parliament is set to adopt the directive on cross-border health care at its plenary session on 18 January.
The agreement, which aims at clarifying the rights of patients when they seek treatment in another member state, is expected to be cleared by EU health ministers at their March meeting.
In their latest conclusions on the issue, ministers stressed that ''health should not be considered as a budgetary adjustment variable," despite growing financial pressures on healthcare systems due to the crisis and an ageing population.
"Preventive health measures should not be solely regarded as expenditure, but also as an investment which may reduce expenditure,'' the ministers added.
However, views on cross-border treatment have raised far more controversy.
The proposed directive has so far needed two readings by the EU institutions, owing to concerns raised by many member states over the ability of their health systems to cope with a potential influx of patients from abroad.
The European Commission estimates that, at present, treatment for foreign patients accounts for an average of 1% of total public healthcare expenditure in the 27 member states – an absolute cost of around €10 billion a year.
With the new directive in place, public authorities fear an increase in the number of foreign patients, especially in border areas where the quality of services is comparatively higher. Coping with an influx of new patients could have a negative impact on the level of services, argue critics of the proposal.
Doomsayers have so far been proved wrong by European's low inclination to seek treatment abroad, especially for serious conditions. A Eurobarometer survey conducted in May 2007 found that only 4% of EU citizens said they had received medical treatment abroad in the previous 12 months.
However, a majority of interviewees (53%) said they would be ready to undergo treatment in another EU member state, with Cyprus (88%) and Luxembourg (76%) citizens showing the most enthusiasm.
Budapest thermal waters and dental care
The directive doesn’t just represent a step forward for EU patients. It is also a huge opportunity for member states that want to encourage health tourism.
And Hungary, which assumes the rotating six-month EU Presidency on 1 January, is a leader in the field.
Hungarians are keen to see patients head to Budapest, where they could get quick and cheap treatment and, while at the same time, take the opportunity to visit the country's stunning capital.
''Exploiting the untapped healthcare potential of Europe is a key priority of our Presidency,'' Zoltán Kovács, junior minister for public administration in charge of communication, told EurActiv.
Blessed with natural thermal waters appreciated by the Romans and equipped with state-of-the-art medical structures, notably for dental care, Hungary has marketed itself for years as a top destination for health-based tourism.
Thousands of Germans, Swiss, Brits and other Europeans go there every year to get professional, cheap and fast medical treatment. Booking can be done just a few days before an appointment and clinics are regularly opened during the weekend.
Clinics in Budapest are particularly known for their dental treatment, for which Hungary is considered one the best countries in the world.
''We began focussing on dental care because it is one of the health services that are less likely to be covered by public insurance schemes,'' explained Csilla Mezoesi, who is in charge of public relations at the Budapest-based clinic Dental Travel.
NEXT STEPS
18 Jan. 2011: European Parliament plenary expected to adopt the directive on cross-border health care.
7 March 2011: EU health minsters expected to approve the directive in the Employment, Social Policy, Health and Consumer Affairs (EPSCO) Council.
http://www.euractiv.com/en/health/hungary-push-healthcare-tourism-eu-helm-news-500607
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