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Inhalt des Dokuments

Towards a renewed Community framework for safe, high quality and efficient cross-border healthcare within the European Union.

Palm W, Wismar M, van Ginneken E, Busse R, Ernst K, Figueras J
In: Wismar M, Palm W, Figueras J, Ernst K, van Ginneken E (eds.) Cross-Border Healthcare in the EU: Mapping and Analysing Practices and Policies. Copenhagen: WHO on behalf of European Observatory on Health Systems and Policies, S. 23-46





Since 1998, the construction of a new legal framework to enable cross-border care for citizens has been debated in the EU. While existing legal instruments for organizing free movement of professionals and patients have been reviewed and modernized, the ECJ has played an important role in further extending entitlements to cross-border care. At the same time this has created legal uncertainty as to the wider implications of these rulings and their interaction with existing frameworks. Since the ECJ issued its first judgements in 1998, several attempts have been undertaken to restore coherence and legal clarity as to the rights citizens have to seek health care outside the country in which they are insured or with which they are affiliated for statutory health care coverage. By means of proposing a new Directive on the application of patients' rights in cross-border health care, the European Commission initiated a new phase in the political debate in July 2008. This chapter presents and reviews the main issues with regards to this proposed directive. It starts by summarizing the long approach to the proposal - a process which still had not reached its final end point at the time this chapter was written. 10 The chapter recalls the different regulatory frameworks for cross-border care and the various attempts that have been carried out to restore coherence between them as well as to increase legal clarity. Special attention is drawn to the underlying policy problem related to developing a renewed legal framework for cross-border care in the EU, to explain why it has taken so long for an agreement to be reached and why previous attempts have failed. When looking at the proposal itself, emphasis is placed on the main points and stumbling blocks in the discussion within both the Health Council and the European Parliament in its first reading.