WRITTEN QUESTION E-2389/01 by Christopher Huhne (ELDR) to the Commission. Health care.
Date: 2001-08-20
Institutions: European Parliament, Provisional data
Subjects: EU Member State, EU national, free movement of workers, health care, social security, social-security benefit

C 115 E/70

Official Journal of the European Communities

EN

16.5.2002

The Commission has recently published a Communication on the elimination of tax obstacles to the cross-
border provision of occupational pensions (1). The Commission considers that discriminatory tax treatment
of pension and life assurance policies concluded with providers established in other Member States is
contrary to the fundamental freedoms of the EC Treaty. The Commission will monitor the relevant
national rules and take the necessary steps to ensure effective compliance with the fundamental freedoms
of the EC Treaty.

(1) COM(2001) 214 final.

(2002/C 115 E/074)

WRITTEN QUESTION E-2389/01

by Christopher Huhne (ELDR) to the Commission

(20 August 2001)

Subject: Health care

Will the Commission give its view of EU law on the circumstances under which a Member State must pay
for the health care of one of its citizens in another Member State?

Answer given by Mrs Diamantopoulou on behalf of the Commission

(19 October 2001)

The Commission wishes to draw the Honourable Member’s attention to the fact that Community rules
exist concerning the coordination of social security systems; these rules are contained in Regulations (EEC)
No 1408/71 (1) and No 574/72 (2), which feature a detailed chapter on sickness benefits whose purpose is
to offer real protection to persons moving within the Union. These regulations are designed neither to alter
the structure or content of national social security legislation nor to harmonise these legislations. Their
basic function is to coordinate these laws at Community level.

Pursuant to these Community rules, there are three circumstances in which health benefits may be funded
by the sickness insurance institution with which a person is registered although the benefits are provided
in another Member State:

6 when the person resides in a Member State other than the one in which he is insured (such as a

frontier worker);

6 when unforeseen emergency care is provided during a temporary stay in another Member State (for

example, during a tourist visit);

6 when a person intentionally travels to another Member State with a view to medical treatment and has
obtained an authorisation to do so from the sickness insurance institution with which he is registered.

In these three circumstances the health benefits are provided in accordance with the legislation of the
Member States providing them, but the costs are charged to the sickness institution with which the insured
person is registered.

The authorisation system provided for by Regulation No 1408/71 when a person travels abroad with a
view to medical treatment leaves the Member States wide discretion as regards granting or refusing
authorisation and mandates authorisation only in strictly defined circumstances. The competent
institutions have been given responsibility for authorisation because it is important that the Member
State institutions be able to fund treatment provided outside their territory so that they can reimburse the
institutions of the Member States in which the treatment has been provided.

The Honourable Member should note that the Court of Justice, while acknowledging the validity of the
authorisation system enshrined by Regulation No 1408/71, has reinforced the rights of insured persons as
regards the reimbursement of medical services provided in another Member State, on the basis of the
provisions of the EC Treaty enshrining the freedom to provide services and the free movement of goods.

16.5.2002

EN

Official Journal of the European Communities

C 115 E/71

The Court of Justice held that the insured person is entitled to additional reimbursement from the Member
State of registration if the latter’s legislation provides for a higher level of reimbursement than the Member
State in which the services were provided (3). Besides the Court has endorsed the right to reimbursement
for certain non-hospital benefits and medical products, in accordance with the law of the Member State of
registration, even in the absence of authorisation (4). Finally,
in the context of a case concerning the
reimbursement of hospital treatment obtained voluntarily in a Member State other than the Member State
of registration, the Court of Justice held that a national administrative authorisation scheme might be
justified for overriding reasons provided it is based on objective, non-discriminatory criteria which are
known in advance (5).

All the consequences of this case law that has been progressively developed by the Court of Justice are
currently being examined by the Commission.

(1) Regulation (EEC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to

employed persons and their families moving within the Community 6 OJ L 149, 5.7.1971.

(2) Regulation (EEC) No 574/72 of the Council of 21 March 1972 fixing the procedure for implementing Regulation
(EEC) No 1408/71 on the application of social security schemes to employed persons and their families moving
within the Community 6 OJ L 74, 27.3.1972.

(3) See Banbraeckel, C-368/98, judgment handed down on 12 July 2001.
(4) See Kohll and Decker, judgments handed down on 28 April 1998.
(5) See Smits-Peerbooms, C-157/99, judgment handed down on 12 July 2001.

(2002/C 115 E/075)

WRITTEN QUESTION E-2391/01

by Christopher Huhne (ELDR) to the Commission

(20 August 2001)

Subject: Commitology

the Commission give an assurance that

the Insurance Committee and the Banking Advisory
Will
Committee have always respected the undertakings concerning openness in the agreements and regulations
on commitology? Does the Commission regard the behaviour of those committees as a suitable model for
the Regulators Committee and Securities Committee (the Lamfalussy Committees)?

Answer given by Mr Bolkestein on behalf of the Commission

(17 October 2001)

Neither the Insurance Committee nor the Banking Advisory Committee, which are both committees
assisting the Commission, have ever exercised new comitology powers in the period since the Council
adopted its comitology decision on 28 June 1999 (1). However,
the Commission transmits 6 on a
voluntary basis 6 the summary agendas of the Committee meetings to the Parliament. In addition, the
Commission also transmits summary minutes of the meetings of the Insurance committee. To date, no
comments have been received from the European Parliament on any of the transmitted information.

In the case of the Banking Advisory Committee, the Commission has also kept the Parliament updated on
the review of bank capital adequacy rules in meetings of the Committee on Economic and Monetary
Affairs.

In contrast, the European Securities Committee and the Committee of the European Securities Regulators,
which have been set up as internal advisory committees by Commission Decisions of 6 June 2001 (2), do
not act as comitology committees today. As regards the European Securities Committee, such a role has,
however, been proposed by the Commission in the area of prospectuses (3) and market abuse (4). The