WRITTEN QUESTION E-3283/02 by Paul Rübig (PPE-DE) to the Commission. Action to ensure the financial viability of health care systems.
Date: 2002-11-19
Institutions: European Parliament, Provisional data
Subjects: elderly person, health care, health care system, health costs, health policy, liberalisation of the market, organisation of health care, social-security benefit

10.7.2003

EN

Official Journal of the European Union

C 161 E/81

(2003/C 161 E/085)

WRITTEN QUESTION E-3283/02

by Paul Rübig (PPE-DE) to the Commission

(19 November 2002)

Subject: Action to ensure the financial viability of health care systems

In its communication on the future of health care and care for the elderly (1), the Commission went into
great detail about the fact that population trends over the next few decades will lead to serious funding
problems not only in the area of pensions, but also in health care, though within health care other factors
are making that trend even more pronounced. In that communication, the Commission cited financial
viability as one of three objectives to be pursued simultaneously. To achieve that, what is needed above all
is action to make systems more efficient and avoid efficiency shortfalls. In other sectors of the economy,
market mechanisms ensure that such effects take place (up to a point). Health care lacks significant market
features. Usually, for instance, it is not the patient (cid:1) the consumer (cid:1) who chooses the service, but, rather,
the doctor; nor is there any resulting market-driven price formation process between patient and service
provider, since the service is usually paid for by the state or a health insurance fund. It would nonetheless
appear possible, to some extent at least, to embed or, as the case may be, enhance market principles within
health care, e.g. fostering competition between providers plus greater price transparency for the patient, if
necessary through percentage-based co-payments. The communication referred to also stresses the
importance of greater international pooling of experience.

Does the Commission think that action to enhance market features within health care makes sense

1.
and is feasible?

2.

Is the Commission contemplating making moves in that direction?

3. What further steps is the Commission intending to take to realise, in a tangible fashion, the objective
of ensuring the financial viability?

Does the Commission intend to take initiatives to foster and structure the international pooling of

4.
experience?

(1) COM(2001) 723 final.

Answer given by Mrs Diamantopoulou on behalf of the Commission

(20 December 2002)

There is agreement that all Member States face a triple challenge of ensuring access to health care, high
quality of care and the financial sustainability of health care systems. However, it is the responsibility of
Member States to organise health care systems and their funding. Whether in the context of a national
system market-based mechanisms are useful for cost-containment purposes and whether such mechanisms
are compatible with the objective of universal access to high quality care needs to be decided at the level
of each Member State. The Union has no powers to prescribe the use of such mechanisms. However, the
Commission can play a useful role in encouraging the exchange of information on policies to ensure
financially sustainable and universal access to high-quality health care.

The Commission supports the work of
the Social Protection Committee and the Economic Policy
Committee on health and long-term care for the elderly which has so far resulted in a first set of estimates
of the budgetary impact of ageing on healthcare expenditure and on a common questionnaire that was
submitted to the Member States in the first semester of 2002. The replies to the questionnaire are being
examined and a draft joint Commission/Council report synthetizing the findings will be adopted by the
Commission shortly. Options for a more structured co-operation among Member States in the field of
healthcare and long-term care for the elderly will be considered further by the Commission in 2003 on the
basis of the results of the ongoing co-operation at Union level.

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Official Journal of the European Union

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10.7.2003

Moreover, the Commission has launched a high level process of reflection on patient mobility and health
care developments in the Union to discuss key health policy issues,
including quality and access,
information requirements, the scope for co-operation on health care matters, and how to reconcile
national policies with European objectives in general.

The new public health action programme will provide opportunities to support some exploratory work in
this context.

(2003/C 161 E/086)

WRITTEN QUESTION E-3291/02

by Alexandros Alavanos (GUE/NGL) to the Commission

(20 November 2002)

Subject: US visa requirements for Greek citizens

Nationals of all EU Member States apart from Greece are entitled to travel to the US without a visa. In
reply to my question H-0428/99 (1), the Council indicated that the US Attorney General had approved the
inclusion of Greece in the ‘Visa Waiver Pilot Programme’ which currently includes all other EU Member
States and that meetings with Greece at expert level are now being held for this purpose.

In view of developments regarding the November 17 organisation whose activities in Greece were the
principle reason for the US decision to impose visa requirements on Greece alone among the EU Member
States:

1. Can the Commission say what progress has been made by at the meetings of experts?

2.

In view of the above developments,
authorities with a view to ending discrimination against a European Union Member State?

is it in a position to make direct representations to the US

(1) Oral reply of 15.9.1999.

Answer given by Mr Vitorino on behalf of the Commission

(20 December 2002)

The Commission is aware that reciprocity with regard to visas raises a number of issues, including the one
referred to by the Honourable Member.

In the proposal amending Council Regulation (EC) No 539/2001 (1) which it adopted on 28 November
2002 (2), the Commission states that it intends to examine in depth the purpose and scope of the principle
of reciprocity where visa policy is concerned and that it plans to present a report to Parliament and the
Council by 30 June 2003.

(1) Council Regulation (EC) No 539/2001 of 15 March 2001 listing the third countries whose nationals must be in
from that

possession of visas when crossing the external borders and those whose nationals are exempt
requirement, OJ L 81, 21.3.2001.

(2) COM(2002) 679 final.