WRITTEN QUESTION E-1524/03 by Erik Meijer (GUE/NGL) to the Commission. Compulsory payment of contributions for health care in a Member State other than the state of residence and the health care services used.
Date: 2003-05-06
Institutions: European Parliament, Provisional data
Subjects: free movement of persons, health care, health insurance, pension scheme, residence, retired person, social-security benefit, social-security contribution, social-security harmonisation

21.11.2003

EN

Official Journal of the European Union

C 280 E/161

Although the application of health protection measures falls to the authorities of the Member States the
orientation for immediate and future actions will focus on the following issues:

(cid:1) Rapid detection of all suspect cases of SARS through good surveillance.

(cid:1) Protection of those at risk of infection from the cases through effective isolation of SARS patients in

hospitals, including measures to protect carers.

(cid:1) Particular attention to be paid to air travel, which has been an important factor in the spread of SARS,
notably to standardised screening of passengers leaving affected areas, onboard advice to passengers
and effective information at ports of entry from infected areas.

(cid:1) The importance of raising awareness among professionals and public and the timely and accurate
reporting and sharing of information with other countries, in particular EEA/EFTA countries, acceding
and candidate countries and with the WHO. Co-operation should also be developed with other
partners, such as airline companies.

The Council also took note of the Commission’s intention to submit a proposal to create a European
Centre for Disease Prevention and Control.

In the case of controls at the external borders, each Member State conducts these controls in accordance
with the provisions of Chapter 2, Title II, of the Convention implementing the Schengen Agreement, in
particular Article 5, which lists the conditions for granting entry to third country nationals. The correct
application of these provisions is enough to guarantee an adequate level of safety for the Schengen
countries without the need for new control measures at the external borders to deal with the current
situation.

As for the possible reintroduction of controls at internal borders, it should be stressed that it is up to the
Member States to decide whether to take such a decision in accordance with Article 2(2) of
the
Convention implementing the Schengen Agreement. However, given that the source of the problem here is
in third countries, the Commission considers that the correct implementation at airports of the provisions
on controls at the external borders should suffice.

(1) OJ L 268, 3.10.1998.

(2003/C 280 E/179)

WRITTEN QUESTION E-1524/03

by Erik Meijer (GUE/NGL) to the Commission

(6 May 2003)

Subject: Compulsory payment of contributions for health care in a Member State other than the state of

residence and the health care services used

Is the Commission aware that the free movement of persons and freedom of establishment has
1.
resulted in many people no longer being dependent on residence in their Member State of origin for their
income, including many pensioners who settle in areas with warm climates and attractive recreational
facilities, such as the coastal areas of Spain?

2.
Is this influx of new residents resulting in a relatively heavy burden being imposed on the Spanish
social security system, which has to meet the needs of local residents on low incomes with few doctors
and facilities, thus resulting in growing waiting lists?

Can the Commission confirm that EU Regulation (EEC) 1408/71 (1) requires persons in receipt of a
3.
pension or social benefit from their Member State of origin to pay contributions in that State to cover
their entitlement to health services in another Member State where they have chosen to live? Does this
mean that people may be required to pay for a much broader or limited package of provisions than is
there is no relation between the level of
available in the Member State where they live, so that

C 280 E/162

Official Journal of the European Union

EN

21.11.2003

contributions and the range of services to which they are entitled? To what extent is this compatible with
the principle that people within the EU must not be disadvantaged from the point of view of the free
movement of persons and freedom of establishment?

4. What would the implications be if some of the provisions that are now covered by the Exceptional
Medical Expenses Act (AWBZ) in the Netherlands were transferred to the Sickness Insurance Fund, as a
result of which the remaining AWBZ contribution would mainly or primarily cover services not available
in Spain? Would it not be better if they could pay for additional provisions in Spain instead of in the
Netherlands?

5. What measures is the Commission taking to ensure that the pressure of foreign residents on the
Spanish social security system does not become too great and prevent a large group of insured persons
from continuously complaining about high contributions and limited health care services?

(1) OJ L 149, 5.7.1971, p. 2.

Answer given by Mrs Diamantopoulou on behalf of the Commission

(6 June 2003)

The Commission would inform the Honourable Member that, in the absence of harmonisation of social
security systems across Europe, Regulation (EEC) No 1408/71 (1) set up a system of coordination of
national social security schemes in order to provide optimum social security protection for persons
moving within the Union.

Regulation (EEC) No 1408/71 contains provisions entitling persons residing on the territory of another
Member State than that in which they are insured to obtain medical treatment there.

As a general rule, the principles of Regulation (EEC) No 1408/71 provide that the health care shall be
given in accordance with the legislation of the Member State in which the person concerned resides, as if
the person was insured in that country. This system is designed to ensure equality of treatment for persons
residing on the territory of a Member State. Persons residing in a Member State other than the State that
pays their pension will thus be entitled to health care in the Member State of residence in accordance with
the legislation of that State, as if they were insured there. In order to obtain health care in the country of
residence, the pensioner registers with the institution of the country of residence, by means of a form
certifying that he/she is entitled to health care. Once the pensioner is registered with the institution of the
country residence, the authorities of that country can take him/her into account when planning what
medical resources they need.

Regulation (EEC) No 1408/71 also contains provisions determining which institution shall bear the costs
of health care provided to a pensioner. If the pensioner has a pension from a single Member State other
than that in which he/she resides, it is the institution of the country responsible for paying the pension
that bears the costs of health care. The Regulation establishes how the accounts are settled between
institutions: the institution of the Member State of residence receives from the institution of the Member
State responsible for the pension a fixed amount (at present 80 % of the annual average health care costs
for a pensioner in the country of residence) which covers all the health care provided to the pensioner.

In return, the Regulation provides that the institution which bears the health care costs may deduct from
the pension payable by it any deductions of contributions provided for by its country’s legislation.

In certain situations, these rules may indeed result in a pensioner paying relatively high social security
contributions in relation to the services he/she can claim in the country of residence. However, the reverse
can also be true.

The Commission can inform the Honourable Member that a partial solution to this problem has been
found during the negotiations on the proposal to simplify and modernise Regulation (EEC) No 1408/71 (2).
At its meeting of 3 December 2002, the Council reached an agreement on a general orientation for the
chapter relating to sickness and maternity, whereby the pensioner may also obtain health care in the

21.11.2003

EN

Official Journal of the European Union

C 280 E/163

Member State of the institution which pays the costs of the health care for the pensioner (and to which he
may pay social security contributions), provided that this Member State has opted for this solution and is
listed in an Annex included for this purpose in the Regulation.

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

employed persons and their families moving within the Community,
No 118/97 of 2 December 1996 (cid:1) OJ L 28, 30.1.1997.

(2) Proposal for a Regulation of the European Parliament and of the Council on coordination of social security

systems (cid:1) OJ C 38, 12.2.1999.

(2003/C 280 E/180)

WRITTEN QUESTION P-1533/03

by Frédérique Ries (ELDR) to the Commission

(30 April 2003)

Subject: Innovative medicinal products in the enlarged European Union

The enlargement of the European Union became a reality in Athens on Wednesday, 16 April 2003 when
the Accession Treaty was signed by ten new Member States. This historic event has already had a tangible
impact in that the new Member States are already beginning to participate in Community affairs. In this
respect, enlargement gives rise to a number of questions concerning the protection of pharmaceutical
innovation in some accession countries.

The European Commission and the European Parliament have on several occasions voiced the need to
safeguard pharmaceutical innovation, not least by means of the registration data protection granted at the
time marketing authorisation is issued for new products.

It now seems necessary to ensure the full and inclusive application of registration data protection, which is
an integral part of the Community acquis, in the new Member States as soon as they join the European
Union.

There are still certain doubts and fears as regards the situation vis-à-vis registration data protection for
products that are covered within the European Union by a Community marketing authorisation granted
via the centralised route.

Could the Commission indicate, in these specific but very frequent cases:

(cid:1) whether the registration data protection granted under the centralised Community procedure for
placing on the market will apply in full in the new Member States as soon as they join the European
Union;

(cid:1) and whether the marketing authorisations granted by local authorities in the candidate countries to
generic copies of such products prior to accession will become null and void as soon as those
countries join the European Union, with the de facto result that these copies are withdrawn from the
market?

Answer given by Mr Liikanen on behalf of the Commission

(21 May 2003)

The Commission can confirm that
for medicinal products authorised according to the centralised
procedure set out in Council Regulation (EEC) No 2309/93 of 22 July 1993 laying down Community
procedures for the authorization and supervision of medicinal products for human and veterinary use and
establishing a European Agency for the Evaluation of Medicinal Products (1), the data protection set out in
Article 13(4) of this Regulation read together with Article 10(1)(a)(iii) of Council Directive 2001/83/EC of
the Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal
products for human use (2) fully applies in the new Member States as from accession. As a consequence, a
new application for a generic product submitted in the new Member States after accession cannot benefit
from the abridged procedure set out in Article 10(1)(a)(iii) of Directive 2001/83/EC as long as the
reference product is still covered by data protection.