Cross-border issues in the provision of health services: are we moving towards a European health care policy?

Abstract

This paper analyses likely implications of two recent European Court rulings on the provision of health care across borders within the European Union. We argue that the two cases have fundamental implications for the provision of health services as free access to care across borders conflicts with the principle of subsidiarity. We then explore the potential short- and long-term implications of the two cases for all involved in the provision of health services, namely patients, different types of purchasers and different types of providers. We argue that the short-term implications relating to freedom to provide goods and services may lead to re-thinking how services are financed and provided. At the same time, the rulings may lead to greater transparency in health services, with attempts to compare efficiency and prices between providers in different countries. Consumers may benefit directly by gaining access to a product or service that is not available in their country of residence or is available but at a higher cost or lower quality. They may also benefit indirectly in the long term, through greater transparency and efficiency.