Cross-border Health Insurance In The Eu: Opportunities And Challenges

Cross-border Health Insurance In The Eu: Opportunities And Challenges – Introduction The European Union covers more than 4 million square kilometers and has a population of 508 million. Together with its closest neighbors from the EFTA Association, it counts 40 internal land borders between the 28 Member States. Border regions live in 30% of the population of Europe – 150 million inhabitants respectively.

The socio-economic development of the border regions is often hampered due to their remote location and different laws compared to neighboring countries. The border regions experience a barrier to the free movement of workers and services which leads to disadvantages in economic, social and cultural development. In addition, all these factors greatly affect health care systems in border areas. The geographic operating area of ​​businesses and their markets (especially in the case of SMEs), health providers and institutions, skills and training services for workers, educational institutions and local governments often face more obstacles than non-border areas, which makes health delivery less efficient. Furthermore, citizens are limited in their choice and access to health care and there is little room for cooperation in health care. A condition that can create health inequalities.

Cross-border Health Insurance In The Eu: Opportunities And Challenges


Cross-border Health Insurance In The Eu: Opportunities And Challenges

Health care is a national competence and Member States finance, manage and organize their own health care systems. However, regions and local authorities share responsibility and expertise in the sector and the European Union supports cooperation between Member States. Therefore, subnational authorities in collaboration with the European Commission, the European Parliament, Member States and all relevant health stakeholders can work together to address the challenge of delivering health and care in border areas, thus improving health for all European citizens and ensuring health. equality.

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Directive 2011 / 24 / EU on the rights of patients in health care at the border is an important step in European health policies, responding to the needs of EU citizens. This directive guarantees patients’ rights to access safe and high-quality health care across national borders in the EU and their right to be reimbursed for such health care. The effectiveness of the directive varies between Member States and regions and more needs to be done to overcome certain challenges related to documentation, restitution, translation and equal access, to name just a few. While many good practices already exist in the field of cross-border care, it should be noted that cross-border cooperation does not include new challenges such as differences in structures and legislation, fragmented roles and different responsibilities in health care, and much more. a difficult environment for healthcare providers and their markets.

To better address such challenges, on 20 September 2017 the European Commission adopted the communication “Promoting growth and cooperation in the EU’s Border Regions”, showing ways in which the EU and its Member States can address the issue by promoting the integration of services and internal spaces. limits. Communication proposes a set of measures to improve competitiveness and harmony in cross-border areas, especially by addressing other legal and administrative barriers that hinder cooperation and collaboration. Moreover, the Commission’s report on the implementation of Directive 2011 / 24 / EU on the use of patients’ rights in health care at the border emphasizes the need to map and build border and regional cooperation.

With this joint report and thematic network, it is the goal with the “Healthacross initiative” of Lower Austria and all the supporting organizations, to support the European Commission’s efforts to set important challenges for cross-border and regional cooperation in health care and identify successful experiences, which can be expanded. A participatory approach is used, and all stakeholders involved in cross-functional healthcare are welcome with ideas and opinions.

Together, we want to speak with one voice, improve the health and well-being of citizens living in border areas and ensure equal access to quality health care close to home.

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This Joint Declaration is not about medical tourism and the coordination of health systems of Member States. This work aims to support access to quality health care close to home across borders.

When talking about cross-border healthcare one must understand, that border regions offer incredible diversity. The facts of one border region will not match the facts of any other. Therefore, any proposals or changes in health care in border areas must be tailored to the existing conditions. It is impossible to find a “one-size-fits-all” solution.

Differences can be seen in various factors, such as geographical conditions, historical development, culture and languages. Furthermore, every health system is classified differently. A large range of stakeholders (i.e. civil society, interest groups, health professionals, local and regional authorities, governments, insurance and business) and their different importance and different habits of the user, the (potential) patient, shape the health sector. and with it, any ongoing change process.

Cross-border Health Insurance In The Eu: Opportunities And Challenges

When looking at the health care sector one should also remember the sector they are looking at. Often, the focus is too narrow in the hospital and primary care sector. Public health in all its aspects has been left behind. However, prevention and promotion should not be limited to internal borders and within national laws. We therefore emphasize the importance of local and regional initiatives, which create targeted improvements in border areas that can, sometimes less, be adopted in other cross-border areas. Such initiatives are often initiated by citizens, civil society organizations, interest groups or regional and local authorities, because they deal with border issues every day and naturally want to improve them. Participatory methods play an important role, in allowing the citizen to have his voice heard and to gain broad support for change.

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At the same time, we highlight the importance of appropriate funding opportunities for bottom-up initiatives to implement new ideas in frontier areas. Partnerships and cooperation in cross-border areas depend on funds such as the European Regional Development Fund. Therefore, to ensure the continuation of successful initiatives and sustainable improvements, we encourage health to be among the main priorities in the new program period 2021-2027 both within ESIFs and direct funding (eg Horizon Europe).

In February 2019, two bilingual citizen meetings were organized by EPECS (European Patients Empowerment for Customized Solutions) in the Euregio Meuse-Rhine in order to gather the Citizen’s opinion on health. 120 citizens were gathered and gave a positive contribution to their opinion on “justice”, “participation methods” and “benefits of workers in health”. The outcome of these population summits was used as input to the 25th annual RHN conference of the WHO in June, which aimed to explore how to keep people at the center of health and sustainable development policies.

We are calling for an easy and quick way to recognize technical qualifications and skills for all professionals in the health sector. Under Directive 2005/36/EU there is already a modern system for managing the recognition of educational qualifications in the EU. There are professions where automatic recognition is possible, such as nurses, doctors, pharmacists, midwives or architects.

A more extensive range of expertise can be found in other EU Member States but requires more practice. For five professions (i.e. general care nurses, physiotherapists, pharmacists), the European professional card (EPC) was introduced in 2016 in digital and direct communication with the relevant regulatory authorities in a secure way.

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However, this ongoing Directive 2013 / 55 / EU has not been fully implemented by many Member States (In March 2019, the European Commission took further steps in infringement proceedings against 26 Member States to ensure the implementation of EU laws regarding the recognition of technical guarantees) . We encourage the Commission and the MS to fully implement this directive, to look at a wider range of activities, especially with an emphasis on health activities, and to expand them where appropriate. The full implementation of the European professional card and the corresponding digital transformation is also desirable. In particular the healthcare profession, a broad group of workers with different skills, qualifications, training and professional status in all EU Member States, is not regulated and cannot be compared at this level.

A simple and quick way to understand technical qualifications and skills will pave the way for health workers living in border areas to work across the border and at the same time close to home. In practice, rural migration in the best case can be reduced and/or partially prevented. Moreover, opportunities for joint use in health facilities in border areas can be created, which may – at the moment – ​​have a very small pool of qualified workers available.

The Cerdanya Hospital, jointly funded and managed by the health authorities of France and Catalonia/Spain, is the second largest hospital in Europe, and operates within the EU legal framework as the “European Grouping of Territorial Cooperation”. Since September 2014, it provides specialized and emergency health care to 32.000 permanent residents (three times more during tourism). Almost 55% of the population is on the Spanish side of the Pyrenees and 45% on the French side. Many obstacles have been overcome since day one, with no benchmark to compare to. Currently, two major cross-border projects are underway. “When emergencies cross borders” aims to facilitate the operation of the Catalan and French emergency services in each country when necessary. Quick recognition of professional qualifications is helpful

Cross-border Health Insurance In The Eu: Opportunities And Challenges

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