1Maria do Rosário Anjos, 2Joaquim da Veiga Cepeda
1Associate Professor - Lusófona University, Porto, Portugal
Researcher on Portucalense Institute of Legal Researcher and CEAD Francisco Suárez
2Master in Law - Lusófona University, Porto, Portugal
DOI : https://doi.org/10.47191/ijmra/v5-i10-11Google Scholar Download Pdf
ABSTRACT:
Access to cross-border healthcare in the European Union (EU) is promoted by Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011. The aim is to promote patient mobility and the possibility of access to new treatment opportunities and an EU-wide health service. The focus of this paper is the analysis of the Directive, its scope and its consequences in Portugal. The concept of cross-border healthcare provision means the possibility for an EU citizen to have access to healthcare in another Member State, bordering the state of his nationality. The directive imposes rules for patients' access to cross-border healthcare. The idea is to ensure freedom of choice and access to high-quality cross-border healthcare in the EU, and to do so by ensuring patient mobility. As stated by the Court of Justice of the European Union (CJEU), the main objective is to promote cooperation on healthcare between member states, while respecting all national competences on the organization and delivery of healthcare. In this paper we analyze the assumptions of access to cross-border healthcare, from transparent information to the removal of administrative obstacles and treatment costs in host countries. We also analyze the terms of the transposition of the Directive into Portuguese law, and in particular the introduction of the mechanism of subordination to prior authorization.
The methodology adopted is based on a theoretical framework that includes the study of legislation, jurisprudence and reports from the European institutions. We also try to access some data on cross-border health care in times of pandemic from COVID 19.
The results show some inconsistencies in the transposition of the Directive in Portugal and also regulatory flaws. The possibility of "reverse discrimination" between Portuguese and nationals of other member states is one example. Safeguarding the quality of this type of healthcare requires a more assertive intervention by EU health regulators.
KEYWORDS:Competition; Cross-border health services; EU health services market; Reverse discrimination; Services of general interest
REFERENCES
1) Anjos, M. R. (2016). Serviços de Interesse Económico Geral, Concorrência e Garantias dos Cidadãos Usurários - Um Estudo à Luz do Direito Comunitário. Maia: Edições ISMAI
2) Anjos, M. R. & Cepeda, J. V. (2019). O Direito ao Consentimento Informado das Pessoas Incapazes com Discernimento. In: R. M. Gonçalves & F. S. Veiga (Diretores), P. Brito (Coord.), Estudios de Derecho Iberoamericano. Vol. III. Universidade Lusófona do Porto / IBEROJUR- Instituto Iberoamericano de Estudos Jurídicos. Porto. Ed. Lusófonas
3) Duarte, B. C. G. F. (2015). O Problema da Discriminação Inversa e das Situações Puramente Internas no Direito da União. Tese de Mestrado em Direito Público. Escola de Direito da Universidade Católica Portuguesa, Centro Regional do Porto. Porto: UCP,CRP. Available:https://repositorio.ucp.pt/bitstream/10400.14/20454/1/FINAL%20PDF%20Tese%20Benedita%20Duarte.pdf
4) Marques, N. C. (2015). Regulação e Concorrência na Saúde. Conferência proferida na I Jornada da Saúde do Hospital do Santo Espírito da Ilha Terceira, em representação da Entidade Reguladora da Saúde, 6 de junho. Porto: ERS. Available: https://www.hseit.pt/sites/default/files/eventos/IJornadaSaudeHSEIT/ Regula%C3%A7%C3%A3o%20Concorr%C3%AAncia%20na%20Sa%C3%BAde.pdf
5) Mendes, A. M. & André, F. (2017). O setor da Saúde, Organização, Concorrência e Regulação. Conselho Estratégico Nacional da Saúde da CIP, Confederação Empresarial de Portugal. Lisboa: Caleidoscópio.
Online Sources:
1) Court of Jusrtice of European Union (1997). Joined ProcessesC-64/96 e C-65/96, Acórdão de 5 de junho. Acórdão Uecker e Jacquet, da 3.ª Secção do TJCE. (Land Nordrhein-Westfalen vs. Kari Uecker e Vera Jacquet vs. Land Nordrhein-Westfalen). Available : http://curia.europa.eu/juris/liste.jsf?num=C-64/96&language=pt.
2) Court of Jusrtice of European Union. (2011). Processo C-255/09, Acórdão de 27 de outubro. Available: http://curia.europa.eu/juris/liste.jsf?language=pt&num=C-255/09
3) Entidade Reguladora da Saúde (2017) Análise do Impacto da Diretiva dos Cuidados de Saúde Transfronteiriços: Porto, p. 3. Available: https://www.ers.pt/uploads/writer_file/document/2048/ERS_-_Estudo_Impacto_Diretiva_CST.pdf
4) Entidade Reguladora da Saúde - Análise do impacto da Diretiva 2011/24/UE do Parlamento Europeu e do Conselho, de 9 de março de 2011, relativa ao exercício dos direitos dos doentes em matéria de cuidados de saúde transfronteiriços. (2011). Available :https://www.ers.pt/uploads/writer_file/document/37/Directiva_Transfronteirica_11.pdf
5) Entidade Reguladora da Saúde. (2011). Análise do impacto da Diretiva 2011/24/UE do Parlamento Europeu e do Conselho, de 9 de março de 2011, relativa ao exercício dos direitos dos doentes em matéria de cuidados de saúde transfronteiriços. Junho. Documento consultado na versão “em discussão pública”. Junho. Porto: ERS. Available:
https://www.ers.pt/uploads/writer_file/document/37/ Directiva_Transfronteirica_11.pdf
6) Entidade Reguladora da Saúde. (2014). Recomendação do Conselho Diretivo da Entidade Reguladora da Saúde. Agosto. Porto: ERS. Available: https://www.ers.pt/uploads/writer_file/document/1052/Recomenda__o_Publicidade_-_vers_o_para_publica__o.pdf
7) Entidade Reguladora da Saúde. (2017). Análise do Impacto da Diretiva dos Cuidados deSaúde Transfronteiriços. Junho. Porto: ERS. Available: https://www.ers.pt/uploads/writer_file/document/2048/ERS_Estudo_Impacto_Diretiva_CST.pdf
8) European Commission. (2014). Impact of information on patients’ choice within the context of the Directive 2011/24/EU of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare - Final Report. Brussels, August 2014.
Available:https://ec.europa.eu/info/sites/info/files/ cbhc_information_patientschoice_en.pdf
9) European Commission (2015). Evaluative study on the Crossborder healthcare Directive (2011/24/EU) - Final Report. 21 March. Authors: Giulio Zucca, Alberto De Negri, Anda Berényi, András Kaszap; (KPMG), Karl A. Stroetmann (empirica) Peter Varnai (Technopolis). Available:
https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/2015_evaluative_study_frep_en.pdf
10) European Commission (2015)Special Eurobarometer 425: Patients’ rights in cross-border healthcare in the European Union. May 2015. Available: https://ec.europa.eu/commfrontoffice/publicopinion/ archives/ebs/ebs_425_sum_en.pdf
11) European Commission (2015) Member State data on cross-border healthcare following Directive 2011/24/UE – Year 2015. Jonathan Olsson Consulting. Available:
https://ec.europa.eu/health/sites/health/files/ cross_border_care/docs/2015_msdata_en.pdf
12) European Commission (2018) Report from the Commission to the European Parliament and the Council on the operation of Directive 2011/24/EU on the application of patients' rights incross-border healthcare. Brussels. 21.9.2018. Available: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:52018DC0651
13) European Commission (2014) Impact of information on patients’ choice within the context of the Directive 2011/24/EU of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare - Final Report. Brussels, August 2014. Available: https://ec.europa.eu/info/sites/info/files/cbhc_information_patientschoice_en.pdf
14) European Commission (2015) Evaluative study on the Crossborder healthcare Directive (2011/24/EU) - Final Report. Brussels, 21 March. 2015. Authors: Giulio Zucca, Alberto De Negri, Anda Berényi, András Kaszap; (KPMG), Karl A. Stroetmann (empirica) Peter Varnai (Technopolis).
Available: https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/2015_evaluative_study_frep_en.pdf
15) European Commission (2015). Member State data on cross-border healthcare following Directive 2011/24/UE-Year 2015. Jonathan Olsson Consulting. Available:
https://ec.europa.eu/health/sites/health/files/ cross_border_care/docs/2015_msdata_en.pdf
16) European Commission (2015). Special Eurobarometer 425: Patients’ rights in cross-border healthcare in the European Union. Fieldwork: October 2014. Publication: May 2015. Available:https://ec.europa.eu/commfrontoffice/publicopinion/ archives/ebs/ebs_425_sum_en.pdf
17) European Commission (2015) Cross-Border Care, DG Health and Food Safety. Annual Report 2015. Available:https://ec.europa.eu/health/cross_border_care/overview_pt
18) European Commission (2016) Cross-Border Care, DG Health and Food Safety. Annual Report 2016. Available: https://eur-lex.europa.eu/legal-content/PT/TXT/?uri=CELEX:52015DC0421
19) European Commission (2017) Cross-Border Care, DG Health and Food Safety. Annual Report 2017. Available:https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM:2018:651:FIN
20) European Commission (2018). Report from the Commission to the European Parliament and the Council on the operation of Directive 2011/24/EU on the application of patients' rights in cross-border healthcare. Brussels, 21.9.2018. Available: https://eur-lex.europa.eu/legal-content/ EN/TXT/?uri=CELEX:52018DC0651
21) European Parliament. (2019). Report on the implementation of the Cross-Border Healthcare Directive (2018/2108(INI)). Comissão do Ambiente, da Saúde Pública e da Segurança Alimentar do Parlamento Europeu. Relator: Ivo Belet. 29.1.2019. Available: http://www.europarl.europa.eu/doceo/document/A-8-2019-0046_PT.pdf
22) European Parliament - Report on the implementation of the Cross-Border Healthcare Directive (2018/2108(INI)). Comissão do Ambiente, da Saúde Pública e da Segurança Alimentar do Parlamento Europeu. 29.1.2019. available:http://www.europarl.europa.eu/doceo/document/A-8-2019-0046_PT.pdf
Volume 05 Issue 10 October 2022
There is an Open Access article, distributed under the term of the Creative Commons Attribution – Non Commercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/), which permits remixing, adapting and building upon the work for non-commercial use, provided the original work is properly cited.
Our Services and Policies
Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected.
The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.
International Journal of Multidisciplinary Research and Analysis will publish 12 monthly online issues per year,IJMRA publishes articles as soon as the final copy-edited version is approved. IJMRA publishes articles and review papers of all subjects area.
Open access is a mechanism by which research outputs are distributed online, Hybrid open access journals, contain a mixture of open access articles and closed access articles.
International Journal of Multidisciplinary Research and Analysis initiate a call for research paper for Volume 07 Issue 12 (December 2024).
PUBLICATION DATES:
1) Last Date of Submission : 26 December 2024 .
2) Article published within a week.
3) Submit Article : editor@ijmra.in or Online
Why with us
1 : IJMRA only accepts original and high quality research and technical papers.
2 : Paper will publish immediately in current issue after registration.
3 : Authors can download their full papers at any time with digital certificate.
The Editors reserve the right to reject papers without sending them out for review.
Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not conform to the format and style of the Journal may be returned to the authors for revision or rejected. The Journal reserves the right to make any further formal changes and language corrections necessary in a manuscript accepted for publication so that it conforms to the formatting requirements of the Journal.