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Draft health directive: reinforced 2-speed medicine?

(B2 archives) The health services directive is drawn up by the services of European Commissioner Markos Kyprianou (photo). A first draft has just been presented – in inter-service consultation (all relevant Commission services must give their opinion). Project which I learned about and detailed in Europolitics.

The content of this text is complex. At the same time, it seems to give rights to patients but, at the same time, it does not place all patients on the same level of equality. At the same time, he seems to want to apply the Court's jurisprudence but, at the same time, he does not apply all the elements, being content to cherry-pick some. In fact, it abandons the principle of solidarity which guides social security systems and is forgotten in favor of a new, more individualistic logic.

Let us point out some hiatuses, contradictions and problems of this project:

This text thus establishes a new method of reimbursement for patients who intend to travel abroad to receive care. But it does not provide for prior support (unlike the current situation). Concretely, only patients who will be able to advance their care (in hospital matters, this represents several tens of thousands of euros) will be able to benefit from this directive. To go quickly, the rich or the best trained (those close to the medical field).

It leaves a whole set of elements unclear: what about liability in the event of damage, monitoring of care upon return to the country, the reasonable time limit for remaining on a waiting list, etc.

It does not resolve the most important problems currently facing the health sector: the growing shortage of jobs in a number of sectors, the compensation between the countries which train doctors and those which welcome them, and above all the interpretation of competition and internal market rules (dominant position, agreement, freedom to provide services, etc.) in the face of specific health service situations (hospital card, need for approval, establishment of clinical or hospital services, etc.).

Finally, while its objective is “quality of care”, it does not establish a universal obligation of care services for all European residents (although this type of obligation has already been established in a number of directives: banks , posts, transport).

While the “two-speed medicine” system already exists in practice, this text does nothing to compensate for the differences, on the contrary reinforces and accelerates them, by disrupting the health services from which the most benefit. large number. The legal basis chosen for action “the internal market” is moreover symptomatic of the “liberal” vision which governs this project (the bases “public service”, “social security”, “public health” were thus left aside because too much binding).

Being a little caustic, the provisions of the first draft Bolkestein directive, on “services”, were more “balanced” and “reasonable” than this draft!

(Nicolas Gros-Verheyde)

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).

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