Are you dissatisfied with the quality of the health service in your region? Have you heard of a very good specialist in Germany? Is the waiting list for the exam that your doctor prescribed for you too long? According to the Directive of 9 March 2011 which will come into force in Italy (as in the other member states) starting from 25 October 2013 you can be examined/treated for free in any State of the European Union. To find out more, Firstonline interviews Ilaria Passarani, senior health policy officer at the European consumer organization.
FIRSTonline – What will change with the entry into force of the European directive 2011/24/EU?
“At the moment, European citizens who find themselves abroad for tourism or work reasons and who undergo medical examinations/treatments in a third country are already protected by Regulation 14.08.71 on the basis of which they will be reimbursed by the Italian state for the medical expenses they had to pay. Starting from 25 October 2013, when directive 2011/24 will enter into force, European citizens who decide to go abroad for the sole purpose of being treated or to undergo specialist visits.
FIRSTonline – What costs will be covered by the Directive?
“For specialist visits abroad there is no need for prior authorization from the ASL. It is still to be decided at the national level whether the State will pay directly for the specialist visit or whether the patient will only be entitled to the subsequent reimbursement. According to the Directive, it establishes that it would be preferable to avoid the burden of advance payment for the patient, but the discretion in this area is left to the State. For hospital treatments the situation is different: if, for example, it is a matter of treatments that require hospitalization, and which have higher costs, it is necessary to request in advance the authorization of the local health authority which will be required to respond within pre-established times and to motivate any refusal of reimbursement. The reimbursement for the healthcare service provided abroad on the basis of the Directive will be equivalent to the cost of the same service in the country of origin. The difference between the rate requested in the foreign country and the rate applied in the country of origin will be integrated by the patient. It is important to underline that the Directive only covers services that are also provided in the patient's country of origin; experimental treatments or treatments for rare diseases are not included; it is hoped that the European Parliament will be able to extend the economic coverage to these services in the future”.
FIRSTonline – How will patients make an informed choice, that is to know the characteristics of the foreign healthcare offer?
“According to the directive, it is the task of each Member State to create information and contact points that provide the necessary information regarding the quality of care, information on individual doctors and waiting times. Probably in Italy these points will be created by the local health authorities. One of the objectives of the Directive is in fact to increase the transparency of the information available on the levels of quality, efficiency and skills of the medical personnel in the member states”.
FIRSTonline – In your opinion, what effects will this new Directive have in Italy?
“It's hard to predict. The goal at European level is to fill a regulatory gap and, as I said before, increase transparency for patients. In Italy, the quality of the health services offered is patchy and this leads to strong flows of internal migration usually from South to North. It is therefore possible that, given this new "freedom", Italian patients who can plan an operation will turn to foreign offers but, if this opportunity is exploited, it will also be possible to attract patients from abroad and will therefore be a new opportunity to increase the offer for our poles of excellence”.
