A survey of medical payments in Europe from the
perspective of a British Retired Person
1. EEA MEDICAL COSTS Paid by the
Published Average Costs as at
|
Country |
Average cost per person. |
Year |
Euros
|
|
|
Article 95 (annual) |
2007 |
5,202.72
|
|
|
Article 95 (annual) |
2007 |
4,558.33
|
|
|
Article 95 (annual) |
2006 |
2,704.45
|
|
|
Article 95 (annual) |
2007 |
3,242.51
|
The
amount demanded from EEA countries for any foreign
pensioner (E121 holder) resident in the
Figures originate from The
Freedom of Information Team,
Department of Health, Room 317, Richmond House, 79
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2. Care provided...
Are we to understand that 70% of the cost to the
patient in France is 5202 euros -- but in Spain 100% of the cost is only 3242 euros
and only 2704 euros in Italy (Italy for 2006 – but is 2006 so different from
2007 – both are before the collapse of the £ and the recession)! Is there not something amiss?
It is
abundantly clear that although UK payments to France are 60% higher than to
Spain and 92% higher than to Italy the apparent benefit to the elderly
expatriate in France is far far less.
One
might say that the
One
will also notice that the amount asked in reverse by the
It would seem from a paper previously forwarded to me that the Dutch emigrant
is facing some similar kind of confusion.
The sum to be paid is calculated by the country
of residence. Though the procedure is described in Article 95 of EU
Regulation 574/1972 * see link at bottom
,
the calculation is far from transparently accountable. [The Article 95
is quoted by the Dept of Health in the table above.] This EU
Regulation is 38 years old and dates from the time before the regular use of
computers in every office. The
The
charging system at the local level in
This is
a point which needs urgent clarification!
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3.
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.”
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
****************************
Explanation in
plain English….
One may rewrite
paragraph 1.:-
1.
1st
phrase
A person who receives a pension
from the
That surely means that he should receive total health-care
totally freely. THAT is the legislation
of the
2nd phrase
The health-care shall be
provided at the expense of the
The French Pensioner pays according to his means, and the nature
of the illness. The only reference in
this regulation relating to costs is that the
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4. Equitable treatment of the
Elderly
From the perspective of the British pensioner it is
blindingly obvious that his/her care support in cash terms is inequitable
across the EEA.
Whereas his/her individual costs are zero in the
But then one may argue that the treatment available
is variable. But then again, for those
people resident within the
Should it not be desirable that the British elderly
expatriate is treated equitably across the EEA,
within the limits of the local medical service available?
The
same costing system should apply everywhere for British retired people who
receive a British Old Age Pension.
In extension, is it not desirable that any elderly
expatriate of any EEA nation is treated equitably
across the EEA compared to their home nation?
5. The unequal costings
at present – The situation in reverse.
Whereas the British OAP in France is provisioned
from the UK grant at a high charge of 5202.72
euros for 70%-80% care, a French retired
person in the UK is provisioned at 100% care for £3368.98 charge (=4593.8 euros
at 2007 exchange). This seems
extraordinary!
6. How to achieve an equitable condition of costing.
The costs to the patient and to the competent State
should surely be related to the Social Security contract which exists between
the patient and the competent State.
In France for instance it is an approximate 70%-30% (variable) ratio cover for the State on the one
hand and the French national patient on the other who pays Social Security
contributions during his/her working life.
In the
Logically the ‘competent’ State, responsible for the
health costs of the Old Age Pensioner as
is clearly stated in EU law (viz. Article 24 of EU regulation 883/2004)* see link at bottom should pay the costs as is normal for that pensioner at home.
One could suggest that for a retired French person
in the
For a British elderly person in
For
France it
would be far more simple if the full costs for treatment were transferred
between
The Carte Vitale which all expatriate pensioners in
A similar system would work in reverse for French
OAPs and the CPAM would do as it does now either
raise the supplement of
+/-30% from a mutuelle or charge the
patient. The CPAM
would have details of the French pensioner.
Similar exchanges could occur between other
countries. The State of residence could
charge the competent State the costs, and the competent State could sort out
the costs to the individual or the insurance company.
In effect the charge arises exactly as it would as
though the patient was living in their home nation which is the ‘competent’
State for these charges.
This establishes the link most strongly between the
‘competent’ State and the individual for whom it is responsible. Moreover the payments would be transparently
clear and fair.
It would also dovetail in neatly with the provisions
of the EHIC
The EU agreement is
thereby simplified and Article 95 of EU Regulation
574/1972 would become largely redundant.
THE
Regulation 574/72 Article 95 paragraph 6 empowers them
to do so. If the Government refuses to
do so then a petition to the EU Commission will be
necessary.
To go (or
return) to the
introduction to this subject on the main blog
site click here
CPAM – Caisse
Primaire Assurance Maladie
NHS - National Health Service
EHIC - European Health Insurance Card.
EEA European
Economic Area (the EU plus
LINKS TO original documents – click on item
EU
Regulations on Health costs -- 883/2004 Article 24; and 1408/1971 Article 28 (As printed above without annotations)
EU Regulation
572/1972 Article 95