Blog AnalysisSocial Policy

Did you like the Bolkestein directive? You will love the Kyprianou directive!

(B2) He was believed to be missing, buried. No, the liberal spirit which animated the Bolkestein directive is still blowing... at the Berlaymont building, the headquarters of the European Commission... This December 19, the European executive should, in fact, present a proposal for a directive, prepared by the Cypriot commissioner in charge of Health, Markos Kyprianou.

The Kyprianstein directive. Relying on a few cover-ups, like the “patient rights in cross-border care” ou “quality of care”, this text in fact aims to break down the borders... which remain between a health sector, considered too closed, to the lucrative sector and to help the States which wish to break down their social security model (details see my post in September).

Very precise targets. Two tangible external signs illuminate the intention of the initiators of this text. Instead of preferring the route usually used for reimbursement of care for patients who go to another country of the European Union, that of Social Security, its authors preferred to use the legal basis of the Treaty, which is more flexible, of "indoor market" (section 95). And, instead of the usual DG Employment and Social Affairs (usually in charge of patients' rights for social security), or even the DG Internal Market (which would have been logical given the base chosen), better equipped for this type of project , it is the “small” public health DG which has been appointed leader of this project. Unarmed with personnel specializing in financing and social security law, this DG is also very sensitive to the interests of health industrial lobbies.

The health and social security service must be “normalized”. The Barroso Commission's communications service is barely hiding from this desire to liberalize the market and bring health and social security services into the ordinary commercial category. Reading theprovisional agenda disseminated by the European Commission this week could not be more informative. “The draft guidance explains to patients whether and under what circumstances they can choose providers abroad.” Is there a need for additional comment? From now on, you will no longer say “I’m going to my doctor or I’m going to the hospital” but I’m going to “my supplier” (or “dealer” in English or… Belgian)

Only the Swedish Margot Wallström dared to say No!
According to information received from sources at the highest level, the latest internal meetings at the Commission, sometimes heated, have not changed the situation. Only the Vice-President of the Commission,
the Swedish, Margot Wallström opposed a “substantive reservation” to the text, invoking (rightly) several risks: the appropriateness of the text, legal basis risk of confusion, encroachment on the
competent authorities of the Member States... She was supported, more or less, by her two socialist colleagues, the Spaniard Almunia and the British Mandelson, concerned in more than one way.

The countries most threatened in the short term are, in fact, those where a national health system exists (such as the United Kingdom, Spain, etc.), with strong public funding (Scandinavians) or which are leaving an all-public system ( ex-communists).


Nicolas Gros Verheyde

Chief editor of the B2 site. Graduated in European law from the University of Paris I Pantheon Sorbonne and listener to the 65th session of the IHEDN (Institut des Hautes Etudes de la Défense Nationale. Journalist since 1989, founded B2 - Bruxelles2 in 2008. EU/NATO correspondent in Brussels for Sud-Ouest (previously West-France and France-Soir).