Patient Mobility Directive: One Step Forward or Two Steps Back for Cross-Border Health Care?

Abstract

The European Parliament and the Council of the European Union have adopted, on 09 March 2011, Directive on the application of patients’ rights in cross-border healthcare. This Directive has emerged as a result of the Court of Justice jurisprudence on social security coverage of health care obtained outside the Member State of patient’s social security protection, starting with the well known judgement in Raymond Kohll v. Union des caisses de maladie. The focus of the Court has been on developing a set of patients’ entitlements in cross-border health care, emphasising the individual needs and circumstances of patients seeking health care abroad. The aim of the paper is to investigate the Directive and determine whether it will add (once transposed into the national legal systems) to the current set of patient entitlements and make it easier for those patients to obtain socially covered health care outside the state of social protection, and to discuss the Directive’s application in Croatia, once the country joins the EU. The paper first briefly describes the most important principles that have evolved through the Court of Justice case-law, concerning both the application of freedoms guaranteed by EU primary law (namely, freedom to provide and receive cross-border health care services) and the secondary legislation on co-ordination of social security systems within the Union. This is followed by a detailed analysis of the Patient Mobility Directive, namely focusing on the issue whether the Directive actually contributes to patient mobility in the EU, as well as on its relationship with national social security legislation, especially the Croatian one (since Croatia is to become a Member State a few months before the end of the transposition period). Emphasis is placed on the interaction between the social aspects of national legal framework and the internal market as the cornerstone of the European integration. In the end, the paper submits that the Patient Mobility Directive’s impact on actual movement of patients across borders might prove to be, in some areas, counterproductive. Furthermore, the paper stresses the necessity of clarifying the EU legal framework and the need for closer co-operation and dialogue between the EU and the Member States’ relevant authorities, taking into account specificities of individual Member States, and the significance of the Patient Mobility Directive within the described context.

Keywords

• patients’ rights
• cross-border healthcare
• court of justice
• case law
• health care services
• patient mobility directive