Reasons for the European Union

Reasons for the EU by Carol Lavinia Fraser (<link) 

Carol Fraser wrote the following on the Forum  site Survive France Network

  She is stating why the EU is important to Britain and thereby the citizens of Britain.  I have added some comments in purple.

The first two items are so frequently indicated as reasons why Britain should leave the EU.  But they are on a continental scale what every honourable governing body does from countries to communes.  It is a matter of supporting the less economically developed regions, districts and individuals for the good of all.
 1.  The UK puts in £12 billion into the EU.  It gets back £6 billion.

2.  Each person pays €195.82 in and receives €108.75

From the developing economic strength of the less economic areas one gets trade.  That is what items 3 and 4 are about.
 3.  The free market is worth £227 million in exports to the UK - walk away from that?

4.  The new digital market which is in the process of being set up is estimated to be worth €451 billion and millions of new jobs - walk away from that?

5.  One of the biggest receivers of EU funding is agriculture.  Would our farmers get any funding from a UK government? Risky. Probably a hike in food prices, we all know they do not need much excuse to do that. 
The beauty of the landscape and the intimacy of food producers with the consumers (e.g. such as farmers' markets) depend on subsidies.

6.  Britain together with the EU is a world leader in the field of science and technology.  This is funded by the EU and includes Europeans in the university faculties.  This would go!  The EU is encouraging training of British (and other) students across Europe via the Erasmus programme (which see) - Brexit would probably cut it dead.

7.  Free trade into one of the biggest markets in the world.  America and China want the UK to stay leaders in the market and both have specified they would not be interested in the UK if it is out.  The car industry has warned Cameron to stay in Europe.  What are the implications of that?  The EU has over 50 trade deals globally which we have access to because we are in.  Estimate in lost jobs 2 million.

8.  London and the city are the world leaders in finance.  Implications of an out? Nobody knows!

9.  Security.  Loss of the European arrest warrant and cooperation between police and intelligence sources.  Police chiefs are worried about this one.  Turn the clock back to 1939 and Britain stands alone?  In the event of an 'out' a border would have to erected in Ireland with possible repercussions of kicking off the troubles again.  On the home front the Scots are very unhappy with the possibility of any out and are threatening another referendum to allow them to stay in the EU.  The world is currently in turmoil and we have the strength of a united Europe to take comfort from.  Winston Churchill said after the war the only way for there to be lasting peace in Europe was to be united.  How right he was.

10.  Each British subject has the protection of the European Bill of Human Rights.  Cameron said he will rewrite this into a British constitution.  Wow I for one do not TRUST him to do that.

11.  We each have freedom of movement in the EU and many of the low paid jobs are being done by Europeans, including Portuguese nurses in the health service.  The NHS is graunching (grinding/creaking) now, what would happen if they had to go home?

You might be interested in a conversation on Facebook I had with UKIP Bury.  I put six of the above points and expected an intelligent reasoned response.  What did I get? "Oh Carol you have been reading propaganda".  Right, I thought to ask where he gets his info, the response "The Daily Express".  This being run by a media billionaire baron who no doubt has his own hidden agenda.  I can report on that it was like talking to cotton wool.

In conclusion I would recommend you all sign up to British Influence and get their newsletter.  The reports are written by university professors and political grandees with much knowledge.  I would further recommend you demand answers from UKIP because so far they have none.  To vote 'out' would be to take a giant leap into the unknown.  They glibly state that we can have our own trade deals.  Estimated time to set these up? Years.

I could go on and I expect you will have guessed by now I am an ardent european.  I live in France and love it here having been here for 10 years.  I do not wish to go home and I furthermore do not want to see the land of my birth go to the wall.

****

The European endeavour is in its infancy. It is not perfect as no new venture is perfect.  Europe has had two millennia of changes, most of them traumatic.  We need now to guide the future, and not stand aside. Britain is one of three great economic powers of Europe along with Germany and France and we three should work together so that the whole does not founder.

Health costs and Democracy for Citizens in Europe

To go to the Index and start click here

More comment on the Government Green paper

Concerning support for health costs in the EU

An example of why the Britons Abroad  in Europe and elsewhere  need Democratic Representation.

I appreciate the comments by readers of my circulars which have caused me to consider a further analysis of the situation on the costs of health care in Europe.

It involves a digging out of information in the EU regulations.

The consultative Green Paper is entitled

“Sustaining services, ensuring fairness”

A consultation on migrant access and their financial contribution to NHS provision in England.”

1.   This Green Paper was issued in July with a date of August 28^th for the return of observations.  This is my immediate concern - The situation is unacceptable that people most affected by certain aspects are given no direct knowledge of this green paper, and no time at all to respond!

2.  The title gives no indication whatsoever that the contents also concern the health costs of British pensioners in the EU.  It is only by rare chance in October that I learned of its existence and quick action ensured that the contents were widely known.   

These concerns were particularly and rightly publicised (especially by The Connexion in France) because of the effect on the health costs of the ‘early retirees’ who would have their support for health care in the wider EU removed. 

Since then I have received comments which result in the analysis below.

The British State Pensioner abroad and treatment under the NHS.

The essence of this analysis is the ability of British State pensioners otherwise resident in other States of the EU to receive treatment under the NHS in Britain.

*See further note below for other British State Pensioners in the rest of the World.

At this present time – if you are a British State Pensioner and have at least 10 years of residence in the UK, but you happen now to be resident abroad, you are NOT entitled to free treatment under the NHS.  However many of us have received treatment in the UK.  Maybe only an eye test, sometimes more. 

[Confusion on this is introduced by the fact that the EHIC –health card – is issued by the UK to all British State Pensioners in the EU.  This card requires the UK to pay the health costs of those travelling to another EU State, which is not their resident State! Thus questioning the situation with regard to visits of pensioners to the UK.

Confusion also exists with the EU law which enables any citizen, retired or not, to travel to another State for treatment if that treatment is not available in one’s State of residence.]

The Green Paper in Annex A makes similar observations to some of the above.  It elsewhere suggests that in future the costing of  health for State pensioners in their resident  State within the EU could be thus affected:-

Clause 6.13  “The benefit to the UK of allowing state pensioners to return for their planned treatment would be a discount of 5% from payments to all countries to whom we make lump sum annual payments for our pensioners. “

The second phrase underlined relating to annual payments, refers to the EU Regulation 987/2009  and  to Annex 3 of that regulation.

This lists the States claiming payment for health treatment on the basis of fixed amounts. They are:- IRELAND, SPAIN, ITALY, MALTA, THE NETHERLANDS, PORTUGAL, FINLAND, SWEDEN, UNITED KINGDOM

It is to the countries listed above that the proposal to cut the fixed amount by 5% would apply.

All other countries claim the actual amount  and would not be affected. – e.g France, Belgium, Germany, Cyprus. etc in the EU…  The actual amount is the amount which the State of Residence has to find – not, as I have ascertained, the actual amount for the treatment as charged to the patient pensioner.  So in France the French State asks of Britain something considerably less than the full cost of the treatment to the patient.

The underlined phrase ‘planned treatment’ seems unnecessary. What is the significance of that phrase?

Then we need to look at EU Regulation 883/2004.  Annex IV to that regulation lists certain States where their Pensioner Nationals can return to their native land for health treatment [there is no reference to ‘planned treatment’ nor in the referenced article 27 here] – they are BELGIUM, GERMANY, GREECE, SPAIN, FRANCE, ITALY, LUXEMBOURG, AUSTRIA and SWEDEN.

Note that the United Kingdom is not listed.  The Green Paper would one supposes result in the UK being included in Annex IV. 

One of my correspondents has informed me that this is indeed what the Government is considering.

The result would be that qualifying Pensioners in the EU beyond the UK  could return quite legally to receive treatment under the NHS  and the confusion and uncertainties which has previously existed would be removed.

*Other qualifying  British State Pensioners resident elsewhere in the World would also benefit from a change in the regulations enabling treatment under the NHS on their occasional visits.  

The relationship of all this to the need for Representation in the Westminster Government.

If we had someone to represent us in Government then this rigmarole would not be necessary.  The DoH could consult with the representatives who would seek opinion from certain groups within each country.  A real democracy could come into being.

It is quite wrong in my view that the Government can produce such a ‘green paper’ and be apparently quite incapable of making appropriate contacts with the people most affected.

This is also so patently obvious with regard to the proposed Referendum.  This would affect the British Abroad in Europe very closely and yet are not in line to be consulted.

It is essential that we are Represented.

http://epetitions.direct.gov.uk/petitions/55085

The address of the DoH is

International Healthcare Team

Department of Health

3rd Floor

Wellington House

133-155 Waterloo Road

London SE1 8UG

Email    migrantaccess@dh.gsi.gov.uk

(Remember that the consultation on the green paper closed on August 28^th 2013)

The green paper is viewable at

 http://www.lefourquet.net/DoH-07-13-healthcosts.pdf

Health Payments in Europe

To go to the INDEX and start click here.

French & European Health payments by the UK for British Pensioners

A/. It is appropriate that the retired citizens who live in France know exactly what expenses are paid  by the British Government for their health care in France.

I am eighty years old, retired, and have never earned any money in France and therefore have never subscribed to the French social security system. The UK is by EU law the ‘competent State’ for the support of our Social Security.  

Like so many others I find the costs of our health care ever rising. Some elderly couples are needing to find beyond 2,000 euros a year  for a top-up health insurance.

Under EU law France is required to ask the UK for the actual costs of our health treatment.  What is meant by ‘actual costs’?

I decided to find out the position.  This is possible via a Freedom of Information request to the Department of Health, London.   I have received very courteous mails from that department and was able to obtain details of all payments to France concerning my health payments since August 1998.  These are confidential and were sent to me by recorded delivery.

I have selected one item here which I have cross checked with details I received from the CPAM (French social security department).

Item  24^th January 2012

CPAM detail

Acte Biologie      

montant dépense (actual cost)      82.08€      taux 60% (amount paid by the French State)

montant payé  (amount paid to the  institution of treatment)          49.25€

participation forfaitaire à retenir   (‘tax’ retained for future collection from patient)   -4.00€

Soins infirmiers  

montant dépense (actual cost)       4.73€      taux  60% (amount paid by the French State)

montant payé  (amount paid to the  institution of treatment)             2.84

Reglé au Laboratoire   (Amount for final settlement to the Laboratory – A sum of  34.72€ was paid by my health  insurance  making up the total of  86.81€ =82.08+4.73€)      

 52.09€.  This is equal to the above 49.25€+2.84€

-------------------------

Breakdown on Claim from France sent to me from the Department of Health, London on items between 15/12/2011 to 22/06/2012.

Soins paramedicaux                           2.84€

Analyses biologiques                        49.25€   i.e = 52.09€

It is clear that the French State seeks repayment of the costs which the French State would find for a French Citizen.  .

B/.The added burden of French taxation on the cost of health.

The above  CPAM detail indicates a ‘participation forfaiture’ of 4€ .   This is a tax which the French Government levies on most health transactions.  It is 1€ for each visit to a G.P. and 0.5€ for collection of a drug at a pharmacy. 

The cost out of one’s pocket for the ‘Acte Biologie’ was therefore increased by 4€. 

The cost to me of this ‘Acte +soins’  was therefore 34.72€+4€= 38.72€. The 4€ was not paid by my insurance.

Over a year, the taxes on health costs accumulate. Together with the above taxes on each medical act as indicated above one must add the taxes on health insurance. During 2012 these taxes amounted in my case to towards 200€.  The more one requires drugs and medical care the higher the taxes. Some pensioners are paying out a great deal more than this in taxes on their health. The more ill you are the more tax you pay!  The French should be ashamed of this taxation on sick people.

C/. Insurance costs

During 2012 the cost of health insurance per month was for me 128.78€ (for a couple – being 64.39€ for one person).  It has since risen in 2013 to 135.78€/month -1629.36€/year).  198.15€/year of this latter sum is a tax paid to the French Government – i.e about 12%.

D/. The EU Laws on the position of health costs.

Regulations 883/2004 and its ‘implementing regulation 987/2009 are those that concern Social Security matters. My interpretations are indicated in orange.

Basic EU Regulation No 883/2004 defines ‘institution’ as ---

"institution" means, in respect of each Member State, the body or authority responsible for applying all or part of the legislation."

The EU laws below are interpreted as referring to the ‘actual costs’ to the institution of the State not the actual costs of the institution that provided the treatment.

EU Regs 883/2004 Article 24 covers the situation relating to Pensioners who have retired to live in another State…I quote verbatim.

“No right to benefits in kind under the legislation of the Member State of residence

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.”

[Observations/Interpretation :- It states that one should receive medical treatment in the same manner as one would expect under the legislation of the UK as if the patient resided in the UK.

                                    The costs are to be borne by the UK – the ‘competent State’ for your social security.

                                    The medical care is supplied as to a French person under French legislation as though he/she were a state pensioner of France.]

Continue....

“2. In the cases covered by paragraph 1, the cost of benefits in kind shall be borne by the institution as determined in accordance with the following rules:

(a) where the pensioner is entitled to benefits in kind under the legislation of a single Member State, the cost shall be borne by the competent institution of that Member State;”

[Interpretation – The UK is bound to pay the medical costs]

“Article 35

Reimbursements between institutions

1. The benefits in kind provided by the institution of a Member State on behalf of the institution of another Member State under this Chapter shall give rise to full reimbursement.”

-----------------------

From the Complementary ‘Implementing’  EU Regulation 987-2009 we read..

“Article 62

Principles

1.  For the purposes of applying Article 35 and Article 41 of the basic Regulation, the actual amount of the expenses for benefits in kind, as shown in the accounts of the institution that provided them, shall be reimbursed to that institution by the competent institution, ………….”

***************************

Commentary.

The difficulty lies in the interpretation of the clause: copied in above--

“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.”

I observe that this clause has no mention of costs.  It relates to the provision of the medical treatment.  This has to be provided as though one is a French citizen.

One notes the contradiction with  the previous clause which states that

‘the pensioner’  shall nevertheless receive such benefits for himself …., insofar as he would be entitled thereto under the legislation of the (United Kingdom) [Member State] competent in respect of his pensions, (as) if he resided in (the United Kingdom) [that Member State].

And…

the cost shall be borne by the competent institution (DoH) of that Member State (the United Kingdom).

So we should get treatment as though we lived in the UK and the UK should cover the cost.

The law appears to me contradictory – It is written that one should receive the medical treatment as though one lived under the legislation of the UK and ALSO as a French citizen pensioner would receive it under the legislation in France.

Many French Citizens – those on 100% CMU cover – pay nothing for their health care.  In short –  the cost to the patient is variable according to the circumstances of the patient! Since the British pensioner has costs covered (in theory!) by the Department of Health, London, it would be reasonable to suppose that these patients should also fall into the 100% cover category. I explore that thought ina European context……

E/. Other European National Citizens in France.

EU laws must be applied equally to all nationals across Europe.  The provision of health care for a state pensioner varies widely from  Estonia to Portugal.   It would seem almost impossible to provide health care for every ‘mobile’ pensioner under two systems of legislation at the same time.  The current interpretation seems inadequate.

It is also a restriction and distortion on free movement of pensioners.   The pensioner nationals who move from most other European countries to the UK obtain free health care.  Clearly with the UK pensioners moving to other countries in Europe, it is very often and usually not so. 

F/. Reform? And a solution?

Would it not be sensible to transfer 100% of the costs from the State of Residence  to the administration of the  ‘competent States’ for the support of Social Security and then that administration should seek appropriate repayments according to the legislation of that State from the  pensioner patient ‘as though they lived in their home country’?  Is this indeed that which the EU regulations are seeking? i.e the costs should be  borne by the 'competent State?

The pensioner should then settle their bills (if appropriate so to do) in a manner according to the legislation of the ‘home’ State.

G/. The need for Representation on these matters at a political level.

There is no-one in the British Government or Administration with any responsibility to look after the interests of British Pensioners in mainland Europe.  

There should be someone who has the responsibility to negotiate with the EU or other national governments concerning the condition of British Pensioners abroad in Europe.

Health in Europe

To  go to the start and also the INDEX  click here

There is much more on this subject which can be accessed through CONCERN 1- which can be raised by going to the start of the blog under 'Concerns'.
------------
 The EU Regulations which cover health are laid forth in the following regulations, which are here linked.

THE EU REGULATIONS:- The year of its formulation is given. The click note is the access point. They are all large and will take time to download.

1. The earliest EU Regulation 1408- date 1971, before the UK joined the EU in 1973. It lays down rules for Social Security. Click.

Each EU Regulation has a twin Implementing Regulation which states how the basic regulation is to be implemented.

2. Implementing Regulation for 1408-1971. 574-1972. click.

3. The above Regulation was modified, and superseded by 883- 2004. It was not brought into operation until May 1st 2010. Many ‘articles’ in the earlier regulation are copied in and some of the earlier are still operative. click

4. The implementing Regulation for number 3 above is 987-2009. click