Tuesday, May 25, 2010

HEALTH MATTERS - Monthly Comment April 2010

A further item has been posted on this subject - Refer to the INDEX for developments.
Few expatriate OAPs in Europe realise that they enjoy health-care support because of EU agreements and THAT THE FINANCE COMES FROM THE UK – in effect from the NHS.

The EU Regulations (essentially 1408/1971 and 883/2004) state that the costs of health care for the Old Age Pensioner is the responsibility of the State to whom the OAP has paid his/her social security contributions. That State will pay your Old Age Pension and support your old age health care! This State is defined as the ‘competent State’ - For almost all expatriate elderly Britons this competent State is The United Kingdom.
Clearly it must be understood that if you have not paid into the Social Security regime of France (or other country) because you had not lived there in an employed category, there is no logical reason why you should be supported under the health-care system of France (or other country)! Only an EU agreement gives you this support. And someone must pay for it! Let us look more closely….

A quote from Article 24 of EU Regulation 883/2004….
“1. A person who receives a pension or pensions under the legislation of one or more Member States and who is not entitled to benefits in kind under the legislation of the Member State of residence shall nevertheless receive such benefits for himself and the members of his family, insofar as he would be entitled thereto under the legislation of the Member State or of at least one of the Member States competent in respect of his pensions, if he resided in that Member State. The benefits in kind shall be provided at the expense of the institution referred to in paragraph 2 by the institution of the place of residence, as though the person concerned were entitled to a pension and benefits in kind under the legislation of that Member State.”
The institution referred to in the following paragraph 2 is indicated as the “competent institution of the Member State” in effect - the NHS. In other words: - you should be treated by the health system of France (your place of residence) and charged to the institution of your competent State (the UK).

Read the highlighted parts again --- It says that you will receive benefits insofar as you would be entitled under the legislation of the competent State (the UK) as if you resided in that Member State (the UK).
That says that if you get 100% cover in the UK you should also get it in France! Or anywhere else in the EEA.
Under the above Article it would seem that we have two situations – firstly The State of Residence is obliged to treat you as though you come under the social care legislation of that State, but the competent State should also ensure that you have the benefits as though you were resident in the competent State. The only way to resolve this is in France to be treated as a French citizen would be (which one is), but that the full cost is picked up by the UK. I have an uncomfortable feeling that the UK is being charged by France at somewhere about the full cost and that the British OAP resident in France is being asked to find up to 30% of the cost as well - via a ‘mutuelle’ or his pocket! This 30% (approx) should not be necessary.

To the current date every EEA country has transferred grants between themselves of a sum of money to cover the health costs of their expatriate OAPs. (Regulation 574/1972 Article 95 – now 38 years old and before the time of electronic data  transmission! And before the UK joined the EU in 1973!) The calculation of these grants are somewhat convoluted.

Two supplementary articles are in consequence appended to this introduction.
Click on a title to view.
2. The costing of the health support of the expatriate OAP in Europe.
This item is updated with additional statistics from the Dept of Health London April 14th. 2010
Is the UK and the British Citizen being ripped off by France? The charge to the UK for pensioners in France is 192% higher than for pensioners in Italy and healthcare in Italy is totally free. This link also links in turn to all the relevant legal extracts. It also indicates the way forward.  

You may well find these items interesting reading.
The whole sorry affair indicates that we need a Minister for the European Expatriate in Westminster. After the general election it will be necessary to write to the Minister of Health.  If necessary a draft letter will be published next month.  In the meanwhile... You may wish to report this matter to your MP or send a petition to the EU Commission.  For  ideas contact me DEBOUTclick
In the meanwhile if you live in France you  must follow the French law and pay up!