Opinion of the European Economic and Social Committee on the "Proposal for a Regulation of the European Parliament and of the Council amending Council Regulation (EEC) No 1408/71 on the application of social security schemes to employed persons, self-employed persons and their families moving within the Community, and Council Regulation (EEC) No 574/72 fixing the procedure for implementing Regulation (EEC) No 1408/71, in respect of the alignment of rights and the simplification of procedures" (COM(2003) 378 final — 2003/0138 COD)
Date: 2003-10-29
Institutions: European Economic and Social Committee
Subjects: ESC opinion, free movement of workers, health card, simplification of formalities, social security, social-security harmonisation

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— The high costs involved in order to adapt the existing
infrastructures ashore and at sea for the use of the new
intermodal loading unit.

Unless this is done, the performance of intra-European short
sea trades will be affected considerably and additional pressures
will be put on short sea shipping operators.

Brussels, 29 October 2003.

The President

of the European Economic and Social Committee

Roger BRIESCH

Opinion of the European Economic and Social Committee on the ‘Proposal for a Regulation of
the European Parliament and of the Council amending Council Regulation (EEC) No 1408/71 on
the application of social security schemes to employed persons, self-employed persons and their
families moving within the Community, and Council Regulation (EEC) No 574/72 fixing the
procedure for implementing Regulation (EEC) No 1408/71, in respect of the alignment of rights
and the simplification of procedures’

(COM(2003) 378 final — 2003/0138 COD)

(2004/C 32/16)

On 10 July 2003, the Council decided to consult the European Economic and Social Committee, under
Article 262 of the Treaty establishing the European Community, on the above-mentioned proposal.

The European Economic and Social Committee decided to appoint Mr Peter Boldt as rapporteur-general
for its opinion.

At its 403rd plenary session on 29 and 30 October 2003 (meeting of 29 October), the European
Economic and Social Committee adopted the following opinion with 71 votes in favour and two
abstentions.

1.

Introduction

1.1.
Regulation (EEC) No 1408/71 has often been amended
to reflect changes to Member State social security systems and
to the case law of the European Court of Justice, which impacts
on the future implementation of the regulation. In 1999, work
began on reviewing the regulation in order to simplify and
modernise it. The European Economic and Social Committee
has commented on the proposed amendments in several
opinions, including: ‘Amendments to Social Security — unem-
ployment’ (1), ‘Social Security — Application’ (2), ‘Social Secur-
ity when moving within the Community’ (3),
‘Extension of

Social Security to non-EU nationals’ (4), ‘Application of Social
Security systems to employed persons when moving within
the Community’ (5) and ‘Social Security systems’ (6).

1.2.
For reasons of consistency, amendments to Regulation
(EEC) No 1408/71 need to be accompanied by amendments
to Regulation (EEC) No 574/72, which covers application of
the former.

In recent years, particular attention has been paid to
1.3.
facilitating the free movement of people within the Union. It
is therefore extremely important that EU citizens can access
without undue difficulty the treatment they need during a
temporary stay in a Member State other than their own.

(1) OJ C 295, 7.10.1996.
(2) OJ C 89, 19.3.1997.
(3) OJ C 73, 9.3.1998.

(4) OJ C 157, 25.5.1998.
(5) OJ C 101, 12.4.1999.
(6) OJ C 367, 20.12.2000.

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Under the current wording of Regulation (EEC) No
1.4.
1408/71, persons temporarily staying in a Member State other
than their own shall be entitled, under the same conditions as
the citizens of the Member State they are visiting, to ‘immedi-
ately necessary care’ or ‘necessary care’, depending on the
reason for their temporary stay (whether they are on holiday,
posted abroad by his employer, a student,
jobseeker, or
working in international road transport).

1.5.
Access to treatment and reimbursement is currently
guaranteed by a form that the insured obtains, on request,
from the social security organisation in his country of origin.
Various forms (E110, E111, E119 and E128) exist, depending
on whether the insured is on holiday, posted abroad by his
employer, a student, jobseeker, or working in international
road transport.

In connection with approval of the action plan to
1.6.
remove obstacles to geographical mobility by 2005,
the
Barcelona European Council decided, in March 2002, to create
a European health insurance card. The spring European
Council in Brussels called for the necessary decisions to be
taken to ensure that the card can be used as of summer 2004.
The card ‘will replace the current paper forms needed for
medical treatment in another Member State’. The aim is to
‘simplify procedures, [without changing] existing rights and
obligations’. The proposal for a regulation is a response to the
Barcelona and Brussels decisions.

2. Gist of the Commission proposal

The main objective of the proposal is to enable the
2.1.
adoption of a European health insurance card. An important
aspect of the amendment is the proposal to harmonise the
right to healthcare and to simplify access procedures.

2.2.
Under the proposal, all groups of persons, whatever
their situation, would be entitled to ‘medically necessary’ care
during a temporary stay in another Member State.

cooperation between individuals and the institutions. The
current regulation only covers cooperation between the insti-
tutions in the various Member States.

In a proposed amendment to Regulation (EEC) No
2.4.
547/72,
instead
the text will only refer to ‘documents’
of models of certificates, certified statements, declarations,
applications and other documents. This would allow the
existing E forms to be replaced by the future health insurance
card.

The Commission proposal to amend Regulations (EEC)
2.5.
No 1408/71 and (EEC) No 574/72 is, then, a continuation of
the Commission Communication of 17 February 2003 (1), and
aims to provide the legal framework for the adoption of the
European health insurance card in 2004.

3. General comments

3.1.
The plan to introduce a European health insurance
card will provide a real fillip for a Citizen’s Europe. However,
the plan is by no means simple, either technically or legally.
The Member States use different criteria for establishing
entitlement to treatment, and levels of preparation for switch-
ing to a single card vary.

3.2.
The European Economic and Social Committee wel-
comes the proposal to introduce the same entitlement to
‘necessary care’ for all categories of persons, which the EESC
had called for in its Opinion on the ‘European health insurance
card’ of 18 June 2003 (2).

European citizens’ real prospects of moving within the
3.3.
European Union will be enhanced if
to
medically necessary care also includes care requiring prior
agreement. A list of such types of care should be drawn up
without delay by the Administrative Commission on Social
Security for Migrant Workers.

the entitlement

3.4.
The European Economic and Social Committee, which
supports the drive to secure a single card, is also aware of the
difficulties posed by the very tight timetable for implemen-
tation of the reform, particularly since only some of the
current Member States and a few of the new countries that are
set to join the EU on 1 May 2004 will be in a position to
introduce a European health insurance card by the proposed
deadline.

2.3.
To this end, it lays down the provisions governing
relations and cooperation between the institutions and persons
covered by the regulation (Article 84a). The proposal for a
new Article 84a covers the duty of mutual information and

(1) COM(2003) 73 final.
(2) OC C 220, 16.9.2003.

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3.5. Work on simplifying and comprehensively reforming
Regulations (EEC) No 1408/71 and (EEC) No 574/72 is
underway and it will not be facilitated by proposals for partial
reforms to the regulations as the work proceeds.

4. Specific comments

The numbering of Article 1(1), covering the amend-
4.1.
ment of the current Article 22, is particularly complicated and
would benefit from greater clarity.

The proposal

for a new Article 84a improves
4.2.
implementation of the regulation by defining the respective
duties of the institutions and of persons. However, the way the
article is worded could make it difficult
to give a clear
interpretation of its scope. In particular, Article 84a (1)(3) is
too general on the obligation to report any changes to personal
or family situation. It should be restricted to the obligation to
report any relevant changes. Similarly,
in Article 84a(2),
‘proportionate’ (Translator’s Note: EN version of COM doc has
‘relevant penalties in accordance with national law’. All other
language versions have ‘proportionate’) is left completely open
to interpretation.

4.3.
The objective of simplifying procedures cannot be
achieved immediately after the proposal has been adopted.
Not all Member States are ready to introduce the card without
a (relatively long) transitional period, during which the old and
new procedures would run in parallel. This could create a
certain confusion and make increased demands for infor-
mation on both the competent authorities and citizens.

4.4.
There will be considerable demands for information
on all bodies within the EU that are likely to come into contact
with the card. Not only will forms and a European card exist
side by side, but each Member State will be able to decide on
the detailed rules for the card. The card could be a separate
European card or it could be a joint national/European card.

Brussels, 29 October 2003.

The Administrative Commission decides on the information
the card is to contain.

Since the intention is to secure uniform entitlement for
4.5.
including during the transitional period, and to
all users,
simplify the procedure for seeking treatment regardless of
whether the patient has the old form or the new card, the
Administrative Commission must waste no time in drafting
the necessary instructions/regulations for dealing with the
different documents during the transitional period.

4.6.
The regulation only addresses the risk of using false
cards in the proposal for a new Article 84a). There could be
major risks of intentional or unintentional misuse, particularly
during the transitional period, and this should be borne in
mind in the Member States.

Article 2(1) states that documents can be transmitted
4.7.
in paper form or electronically. This would, however, require
agreement between the authorities in the sender- and desti-
nation Member States, i.e. many hundreds of bilateral agree-
ments. Since an arrangement of this kind would probably
involve a lot of red tape, a solution that does not require
separate bilateral agreements for transmitting information
electronically should be found as soon as possible under the
TESS programme (Telematics in Social Security).

5. Conclusions

The Committee welcomes the proposed amendment
5.1.
of both regulations and assumes that future amendments to
Regulations (EEC) No 1408/71 and (EEC) No 574/72 can be
included in the major overhaul of these regulations.

5.2.
Under the co-decision procedure, the Committee, as a
consultative body, should have the opportunity to comment
on any changes made to the texts during the decision-making
procedure.

The President

of the European Economic and Social Committee

Roger BRIESCH