EU warns Spain over hospitals' rejection of EU health card

[dipsydoodle]

Source: BBC News

The European Commission is launching legal action against Spain over the refusal of some hospitals to recognise the European Health Insurance Card.

The EHIC entitles EU citizens to free healthcare in public hospitals.

But some Spanish hospitals rejected the card and told tourists to reclaim the cost of treatment via their travel insurance, the Commission says.

A BBC correspondent says the Commission is not accusing cash-strapped Spanish hospitals of trying to make money.

Read more: http://www.bbc.co.uk/news/world-europe-22714147

---

Some background here :

Holidaymakers warned as Spain blocks EHIC usage.

Holidaymakers heading for Spain are being warned that hospitals and clinics are increasingly paying inducements and sweeteners to trap tourists with big bills for treatment.

Tour operators, taxi drivers and even the police are offered backhanders for directing tourists to cash-strapped hospitals, according to insurers.

These hospitals will refuse to accept European Health Insurance, or EHIC, cards, which provide treatment for free, leaving older travellers and those with pre-existing medical conditions particularly vulnerable. Instead, they are presented with hefty bills for their care.

So acute has the problem become that the European Commission has warned Spain that it could take formal legal action, known as an "infringement procedure", after receiving complaints from various EU nationals about the refusal of EHIC cards.

http://www.telegraph.co.uk/finance/personalfinance/insurance/travel/9960030/Holidaymakers-warned-as-Spain-blocks-EHIC-usage.html

[another_liberal]

1. The European Union is dying.

Bit by bit, the European Union is dying, and, perhaps, that is not an altogether bad thing. It may not be possible at this time to merge the poorest and richest of Europe's nationalities under one overarching government. No matter how much the great banking houses want a single currency and universally lax regulations on their industry, a truly unified Europe may have to wait for a time when greed and private property are not the foremost driving forces behind such an entity.

[DetlefK]

3. The EU does not represent a one-europe-government and it's no tool of the big banks.

The EU is a success-story in itself. Countries that fought each other tooth and nail just half a century ago were unified in the first true international federation.
The EU guarantees peace, it guarantees your freedom to travel anywhere you want, any time you want, with a currency that's accepted anywhere. It guarantees a free trade with internationally accepted product-standards.
And the Big Banks have a much harder time in Europe because they have many more political institutions they have to coerce (and because liberalism and socialism aren't dirty words there).

The EU transcends it corporeal state of being a confederation of sovereign countries. It's an ideal, a promise. The promise of equality, freedom and peace. Letting the EU die means abandoning that vision.




By the way, there are so many differences between the states of the USA, why would they stay together anyway? Poor and rich, liberals and conservatives, they just don't mix. It's just not the right time for them to be one country right now. They should split up until greed no longer matters to humans.

[another_liberal]

11. I disagree.

The European Union, as it exists today, is very much under the control of banks and bankers, whether they are temporarily acting as so called "Technocrats," or they are acting as actual bankers. If one can dictate the budget of a nation, in spite of its peoples' wishes, then one is in control of that nation, and its people are not.

[DetlefK]

12. Just because they focus on stabilizing the banks, that doesn't make them bankers.

That's an extremely broad definition you are using here.

[another_liberal]

13. You are right.

Wanting to stabilize banks doesn't make them bankers, having formerly been bankers does. Even those who have never actually worked for financial institutions are so involved with maintaining the banks bottom line profits they can certainly be classified as bankers at heart.

This is all about maintaining and enhancing the status and wealth of the already obscenely wealthy one percent. They view the people of Europe like any other commodity, just like kilos of copper or board feet of lumber. The people mean almost nothing to them. How could they demand the truly brutal kind of austerity they demand if the truth were otherwise?

[pampango]

2. The European Health Insurance Card sounds like a great idea.

Taking action against hospitals that take advantage of "older travellers and those with pre-existing medical conditions" is something the European Commission should do. Having a universal health insurance card does one little good if unscrupulous medical service providers decide not to recognize it.

I wonder if these same Spanish hospitals are urging their government to take away the EHIC from Spaniards who travel to other countries in Europe.

[DetlefK]

4. The EHIC is, for example, included in the state-sponsored single-payer health-insurance.

Germany has set up a network of health-insurers that are by law non-profit-organizations. They cover less than private insurers, but they are cheap and they still offer the minimum you need to get by (basic emergency surgeries, dental health-care, glasses...).

The EHIC is included in the membership card: In case of an accident or sudden(!) illness, the owner is entitled up-front to any necessary health-care and the the doctor/hospital will get paid later by the owner's insurance-company.
Explicit additional temporary health-insurance (you can buy day-wise at banks, automobile-clubs and such) isn't necessary within Europe if you own an EHIC.

[pampango]

5. Thanks for the info, DetlefK. Is the EHIC valid in non-EU countries like Norway and Switzerland?

Or is it specific to the EU?

[dipsydoodle]

6. Details here : All About the E111 / EHIC

http://www.e111.org.uk/about.html

[pampango]

7. Thanks, dipsydoodle. It looks like the EHIC is good in Norway, Switzerland and other non-EU

countries.

Doesn't help an American (but whose fault is that?) but it is a credit to Europeans that they have this coverage themselves.

[dipsydoodle]

8. It does make it clear

that the purpose of the visit to any country covered by the agreement must not be to SEEK medical treatment and also that the person covered , in the case of the UK for example , must be UK resident - not resident in the country where treatment is received.

Whilst "not to SEEK treatment" its different if the NHS has pre-agreed, albeit following a fight, for treatment abroad covered by this :
Under European Community law E112 rule, any EU citizen suffering so-called "undue delays" in receiving treatment in their home country can apply to have the operation in another member state.
http://news.bbc.co.uk/1/hi/health/3155940.stm
I'm not sure if anyone has actually got away with that successfully yet.

Also bear in mind that as that was a UK link I provided and it may be that Norway etc, in our case here, are covered due to another agreement between the UK and those countries - we've had such reciprocal agreements for years.

The subject reminded me to check my own card which as it turns out expired in 2010 since when I've only been to Cuba a few times anyway. The card is is not free - its £23.50. It also has to be returned if the holder either works or lives abroad.

Don't fall into the trap of believing that the healthcare systems in all EU countries exactly mirror the NHS in the UK - they don't. Some of them are a cross between socialised healthcare and a mixture of the state and the private sector.

[muriel_volestrangler]

9. It should be free in the UK if you apply direct

The EHIC is entirely free of charge. However, other unofficial websites may charge you if you apply through them.

http://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/about-the-ehic.aspx

[dipsydoodle]

10. I hadn't realised that

which comes from doing it in a rush before I forgot again.

[newlife_mad]

14. Red tape and who pays the bill

You can hear here similar complaints regarding medical attention received by Spaniards in other EU countries. To suffer this we do not even have to leave Spain, since this country became a de facto federal union of 17 mini states called Autonomous Communities.
I’ll bet the bulk in most cases are surely going to be “red tape issues”. Because after such grandiloquent declarations as: “you have the right to receive treatment anywhere in the European Economic Area (EEA)” comes a lot of fine print.

As UK's NHS advises in its webpage:
"If you're thinking about having medical treatment abroad, it's important to understand how it works and the risks involved ... your European Health Insurance Card (EHIC) does not cover going abroad for medical treatment. The EHIC is for emergency treatment that becomes necessary while you're abroad ...
This is not accessing NHS-funded healthcare in other EEA countries which require other routes:
1. The S2 route (or E112). This is a direct arrangement between the NHS and the state healthcare provider in the country of your choice. Prior approval is required.
2. The EU Directive on cross-border healthcare (or Article 56). Generally, you’ll have to pay the costs of treatment abroad and then claim reimbursement from the NHS when you return. Depending on the treatment, it may be necessary for you to obtain authorization from NHS England, the commissioning board, before receiving treatment.”
www.nhs.uk/NHSEngland/Healthcareabroad/plannedtreatment/Pages/Introduction.aspx

A joint web and initiative by the NHS and their counterpart in the Valencia Autonomous Community addressed to the UK residents, including field initiatives addressed specially to pensioners:

“If you mainly live in Spain and are outside any of the situations mentioned above, you must register for state healthcare in another way to make sure you are fully protected. This can include choosing to be treated as a private patient.
IF YOU ARE A UK STATE PENSIONER/INSURED PERSON WITH A REGISTERED S1/E121 IN SPAIN, THE UK EHIC IS ONLY FOR USE OUTSIDE OF SPAIN WHEN ON HOLIDAY WITHIN THE EUROPEAN UNION.”
[link:http://www.healthcareinspain.eu/events.php|

The aim of the card is to provide free first aid to residents of EU until you can be attended in your country of legal residence, regardless of your nationality. The latter is important because at the end the problem with all this debate is which country is liable for the bill of its residents and this has to do with your legal EU country of residence; in other words: where you pay your taxes; which not always has to do with your nationality.

And as somebody pointed out elsewhere, the problem is akin to the current Euro situation; you cannot put in the same bag countries with different health coverage and how this is financed.

This leads also to the abuse of camouflaged “health tourism”. This can be exploited to circumvent longer waiting times for certain surgery, benefit freely from otherwise expensive replacements (eg hip) that in other countries coverage has to be payed aside. The profile according to the National Health Council is of a pensioner, from the UK, Germany or Belgium seeking a hip replacement or a coronary bypass. This includes those that travel ad-hoc or those who living as residents have not registered themselves as such.

The authorities have reckoned these are not new measures simply that it is lately enforcing the current legislation; and applying reciprocity to the coverage applied in some EU countries to Spaniards to avoid such imbalances. The main goal is to avoid paying treatments that are covered either by the patient's Public Health System or by its Private Insurance or Medical Society.

Nothing new under the sun. It happens locally, if you live in Seville, and want to be operated in say Barcelona or Madrid; unless it is a life/death issue they'll await to receive confirmation from the Andalusian Health Authority that the bill shall be attended. And surely in other countries also.

[hrmjustin]

15. Welcome to DU my friend!