Brussels, 20/06/2014 (Agence Europe) - Although patients can ask to be treated in another member state at the expense of their state of residence if the latter is unable to guarantee the necessary treatment within a reasonable timeframe, this situation should be possible only if it does not endanger the viability of the health insurance system to which these patients belong and does not bring about a “mass health-related exodus” within the EU, Advocate General Cruz Villalon told the Court of Justice of the EU on Thursday 19 June, in his conclusions on the case (C-268/13) regarding a Romanian national who went to Germany for an operation.
Community law offers European nationals the possibility of seeking treatment in a member state other than the one in which they reside. This allows them to benefit from healthcare services in the same way as if they were members of the health insurance regime of that country. The costs are covered by their state of residence if that state is unable to provide the treatment quickly enough, in order not to aggravate their state of health or allow the illness to develop.
In this particular case, the European judges will for the first time have to determine whether the need for medical care in another member state can be based on a shortage of resources in the member state of residence. The Advocate General gave a two-part answer to this question. Firstly, a member state should authorise its nationals to seek treatment elsewhere in the EU if it cannot provide the service due to reasons of an economic nature affecting one of its hospital establishments. This could mean an occasional lack of material resources or a temporary shortage of medical staff.
Secondly, this time on the basis of considerations of an economic nature, the Advocate General concludes that, when these lacks are due to a structural deficiency, a member state should not be obliged to reimburse the healthcare provided to its nationals abroad, even if this covers healthcare services it cannot itself effectively provide. This, he explained, can be justified due to the danger of the emergence of a mass health-related exodus in certain countries and the risk of the resulting excessive economic burden on their health insurance systems. (JK)