Tuesday, January 25, 2011

New Directive on Cross-Border Healthcare

 January 2011.

There are unfortunate differences between the Draft of this Directive published in 2008 and the latest version published very recently in 2011. The new Directive will be operative in 2013.

The devil in the detail is the definition of ‘State of Affiliation’. I quote it here in full. All the heavy print has been added in the recent version and seriously undermines the position of the expatriate in France.

"Member State of affiliation" means the Member State where the patient is an insured person or the Member State where the patient resides if this Member State is not the same as the former.
Where, due to the application of Regulation (EEC) No 1408/71 and Regulation (EC) No 883/2004 respectively, the health insurance body in the Member State of residence of the patient is responsible for the provision of benefits in accordance with the legislation of that state, then that Member State is regarded as the Member State of affiliation for the purposes of this Directive;

This is bad news for British expatriates in France. It means that for this particular Directive then the Social Security of France is supposed to be our effective healthcare cost provider.

The situation becomes ridiculous! I explain step by step – this is for OAPS retired to France.
1. The UK is our State of Social Security Insurance.
2. If we visit the UK we get full health cover costs for medical treatment.
3. The UK provides us with an EHIC (European Health Insurance Card). If one journeyed to Spain then the UK covers us fully for health costs. In other countries it is likely to be variable. [The latter - A contentious point.]
4. The UK pays France for our health care…. The % amount is on the whole questionable. Up to now it has been at the French rate to a French insured person- usually about 80%, but a complicated calculation.

5. If British resident OAPs visit France on holiday and get treatment on the back of the EHIC, they are likely to be charged as though they were a French insured person.

6. If British resident OAPs visit France specifically for health care – then under this Directive they get treatment at the cost at which it would be provided in the UK! i.e 100% of approved costs.
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In my view this absurdity comes about because no-one in the British parliament or Civil Service has any interest at all in the British citizens resident in Europe.
There are inherent inconsistencies in the new Directive to which, I suspect, no British official or politician has given any thought at all. Which British official has the responsibility of vetting these things? None I fear. What MEP even understands that for which they vote?

However I await replies to my representations to the EU parliamentary committee on petitions.
This posting could need revision in due course.