One in ten Europeans live in border regions, finding themselves in limbo between health care systems. While the EU member states implement a European health care by 2013, countries have taken a leap forward. French journalist Marina Daras visits the border of France and Belgium.
Irma Chartier is a French resident in a cross-border area, who last year was diagnosed with a cataract syndrome. She was told she needed eye surgery. Irma sought permission from the French public health care organisation Caisse primaire d’assurance maladie (CPAM or ‘Secu’) to go to Belgium, where the surgery could be done quicker than in France.
In France, the national healthcare system has 15 days to decide whether a patient should receive treatment abroad or not. “When the Secu told me I was able to go to Dinant, I was relieved,” Chartier says. “I couldn’t cope with the situation any longer. I was surprised but very happy.”
Irma Chartier is but one of many cross-border residents seeking care across the border. These regions constitute 15 per cent of the EU territory. Up to 10 per cent of the European population resides in these areas.
Moreover, the border doesn’t feel like a barrier for the residents: in 2006-2007 up to 780,000 European workers were commuting to a neighbouring member state every day.
Since 2004, EU citizens can count on such treatment when crossing the border. With the introduction of the European Health Insurance Card (EHIC) in 2004, urgent medical care is covered for card holders travelling around the EU. The European Union aims to finalise this cross-border health care system by October 2013, when each member state should have implemented the system.
Still, according to a Eurobarometer survey 30 per cent of EU residents do not know they can receive care abroad and those who know are sceptical on how it works.
Jean-Luc Loison, coordinator of cross-border health care in the French region of the Ardennes, explains: “Because of EU agreements, a patient receives the care according to the regulations in the countries where the care is provided. For instance if I see a doctor while on holiday in Belgium, it will be the Belgian health insurance company that will reimburse me on the basis of the Belgian tariff.”
Despite these EHIC emergency measures, some member states decided to extend the directive. Some regions of France, Belgium and Luxembourg planned to build a cross-border health system around a unique medical convention. This initiative is supported by the Franco-Belgian Health Observatory and by
Loison explains how “the cross-border agreements between Belgium and France impose the intervention of a French ambulance on Belgian territory and vice versa in certain border areas. But only when the national service is not available.”
30 per cent of EU residents don’t know they can receive care abroad
The cross-border agreement showed its necessity in the past years. The secretary of doctor Jean-Bernard Colombain, one of the rare ophthalmologists in the city of Charleville-Mezieres (France) says that she had seen the number of patients almost double in the last five years. Meeting patients’ needs became a real challenge in that area and going abroad is the closest and easiest solution for the population, 330,000 of whom are cross-border workers.
As the cross-border health care directive will be finalised in 2013, the ten per cent EU residents living on the border of member states will find their way to the closest doctor, hospital or specialist. Health care is somehow part of the identity of a country, but EU residents share the right to be treated in the same way across the border.