25.02.2019 | Brussels Background If only they knew about it – why the cross border health care directive is the perfect example for the Commission’s comms problem

The Cross Border Health Care Directive could be the poster child when it comes to tangible benefits the European Union has to offer its citizens. Although already passed in 2011, European citizens hardly know anything about it and therefore hardly seize the opportunities they have. How is it possible that the EU only receives negative feedback while substantially improving the life of its citizens?

Ever since the European Union existed in its current form it had to stand against one particular accusation: It is too far away from ordinary people and the legislation it is passing is completely obsolete - just think about the infamous cucumber example each and every one of us has heard a million times. This however, is not really true – the EU is just not really good in selling their achievements. As Commission President Jean-Claude Juncker said in his inauguration speech back in 2014, the European Union has to become better in promoting itself and its benefits and to get closer to the citizens.

One perfect example for this dilemma is Directive 2011/24/EU, better known as the Cross Border Health Care Directive. It is designed to give EU citizens access to care abroad – and reimburse it! The main intention was to facilitate a closer cooperation in particular areas between the Member States. Areas where a cross-border approach provides concrete advantages, such as eHealth and the treatment of rare diseases. It provides people the opportunity to seek medical treatment in another EU member state and claim for reimbursement at home – what a huge achievement!

However, the INI Report of the ENVI-Committee identified three major problems hindering the smooth implementation of the directive: inadequate transposition of the directive, problems regarding reimbursement and last but not least a severe lack of promotion and hence lacking awareness of the citizens. The directive was supposed to be transposed into national law by 2013 the latest but it took most of the Member States longer. This resulted in infringement procedures against 26 Member States. Moreover, reimbursement procedures are very complicated in some Member States which results in patients not taking the opportunity to receive treatment in another Member State because of the bureaucratic hurdles. And last but not least, there is the information problem. Although all Member States have at least one National Contact Point (NCP), fewer than 20% of the European citizens feel well informed about their rights when it comes to cross-border healthcare, according to a Eurobarometer survey. And most people are not even aware of the existence of NCPs. But it’s not only the citizens who lack knowledge about this topic – it is also the health care professionals caring for them.

Promoting initiatives aimed at improving the life of citizens of the European Union, seems to be a thing the European Union does not really excel at. The regular European is not aware of all the benefits the European Union provides for them. Most employees are not aware of the fact that their job is also depending on a strong and stable European Union that supports business throughout Europe. Just a few achievements such as the abolition of roaming costs are directly attributed as a success of the EU. Other achievements such as the strengthening of consumer rights, the fight against antimicrobial resistance or communicable diseases, remain mostly unacknowledged by the European citizens. 

The question remains why the “roaming issue” is closer to citizens than health issues. Indeed, the Commission needs to improve its communication and marketing efforts. But a certain level of support from industry and Member States would certainly help as well. In fact, Member States should act much faster when it comes to implementing the legislation they have substantially shaped and agreed upon. The industry should find a way to openly communicate the benefits of the European single market for keeping business and jobs inside the EU. Only through close collaboration, can we assure that the benefits of the EU such as the opportunity to seek medical care everywhere across the EU actually reach the European citizens.