Legal Implications of Cross-Border Health Care in the European Union

Abstract This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken to provide a financial incentive but may also involve payment risks and administrative burden. For the pathways given by the Social Security Regulations (883/2004 and 987/2009) and the EU Directive 2011/24/EU, we investigate how the associated financial arrangements act on providers, patients and on publicly funded health insurance. First, the Regulations can induce cross-border health care that will increase domestic health care expenditure and may threaten national health policy by setting an incentive for patients to go abroad for health care not covered by domestic health insurance. Second, the financial arrangement of the Directive may induce cross-border health care which will lower domestic health care expenditure. However, due to considerable payment risks and administrative burden on both patients and providers, these benefits will not be reaped in full. Moreover, in the presence of national cost containment policies, the Directive may provide an incentive for cross-border health care that is too strong. Finally, due to the requirement to pay upfront, the financial arrangement also suffers from a lack of equity of access to health care provision abroad.

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Guest editorial. Cross-border health care in the European Union. An introduction

European Journal of Public Health ◽

10.1093/eurpub/7.3.1 ◽

1997 ◽

Vol 7 (3) ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

R Leidl

Keyword(s):

Health Care ◽

European Union ◽

Guest Editorial ◽

The European Union ◽

Border Health ◽

Cross Border

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Current legislation on cross-border health care in the European Union

The Globalization of Health Care ◽

10.1093/acprof:oso/9780199917907.003.0005 ◽

2013 ◽

pp. 83-103 ◽

Cited By ~ 1

Author(s):

Hilko J. Meyer

Keyword(s):

Health Care ◽

European Union ◽

The European Union ◽

Border Health ◽

Cross Border

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Networked Health Care Governance in the European Union

Journal of Health Politics Policy and Law ◽

10.1215/03616878-8706627 ◽

2020 ◽

Author(s):

Dorte Sindbjerg Martinsen ◽

Reini Schrama

Keyword(s):

Health Care ◽

European Union ◽

Driving Forces ◽

The European Union ◽

Border Health ◽

Welfare Policies ◽

Health Care Networks ◽

Cross Border ◽

Administrative Units ◽

The Impact

Abstract The European Union (EU) increasingly resorts to new forms of governance to establish unified health and welfare policies without member states having to transfer their sovereignty to a supranational level. European Administrative Networks are important instruments in the toolbox of new forms of governance, dealing with rulemaking, rule monitoring, and rule enforcement. Operating beyond, but not above, the state, European networks of national administrative units allow for interaction and exchange to coordinate national responses to increased interaction across their borders. The authors use social network analysis to uncover the pattern of interaction among national representatives in two central EU health care networks. Their analysis finds not only that the network in the area of pharmacovigilance has more competences, resources, and capacity to improve the enforcement of EU rules than the network regarding cross-border health care but also that the driving forces behind network interaction appear to differ quite a bit as well. While the supranational character becomes apparent in the former network, network interactions in the latter seem aimed at mitigating the impact of patient mobility rather than improving cross-border health care take up.

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