WRITTEN QUESTION E-0088/04 by Erik Meijer (GUE/NGL) to the Commission. Excessively high premiums charged by Dutch medical insurance companies to policyholders in neighbouring States to offset deficits in the United States.
Date: 2004-01-21
Institutions: European Parliament, Provisional data
Subjects: Netherlands, health care, health expenditure, health insurance, insurance law, insurance premium, price increase

3.4.2004

EN

Official Journal of the European Union

C 84 E/161

(2004/C 84 E/0199)

WRITTEN QUESTION E-0088/04

by Erik Meijer (GUE/NGL) to the Commission

(21 January 2004)

Subject: Excessively high premiums charged by Dutch medical insurance companies to policyholders in

neighbouring States to offset deficits in the United States

Is the Commission aware that Dutch medical insurance companies are charging higher and higher
1.
premiums to their private policyholders living outside the Netherlands,
for example the insurance
company VGZ, which on 1 January 2004 introduced a monthly ‘foreign fee’ of EUR 35 additional per
adult and EUR 17,50 per child?

Is it aware also that in the case of this foreign fee no distinction is made between policyholders living
2.
near the Dutch border, those living in other EU Member States and those living outside the European
Union?

3. What is the Commission’s opinion of the fact that this system means that Netherlands nationals
living in Belgium, where medical charges are comparable with those in the Netherlands, are forced to
contribute to the expenses of Netherlands policyholders resident in the United States, where medical
charges are five times higher than in the Netherlands or Belgium?

4.
Are medical insurance companies allowed to make additional charges such as these in the European
Union and to differentiate between national and foreign policyholders with a view to covering costs
incurred outside the European Union?

If it has answered the fourth question in the affirmative, does the Commission intend to change this
5.
situation by laying down that the level of premiums charged by medical insurance companies within the
EU should in principle be the same and that supplementary charges are only permitted if demonstrably
significant factors make medical expenses higher in the EU Member State in question?

Source: The Dutch newspaper BN-De Stem of 7 January 2004.

Answer given by Mr Bolkestein on behalf of the Commission

(1 March 2004)

The Commission would inform the Honourable Member that the legislation adopted by the European
Union in the insurance sector with the aim of establishing the internal market has put in place a regime
based on the freedom to set terms and tariffs. In Case C-59/01 Commission v. Italy (1), the Court of Justice
ruled that the principle of freedom to set rates applies in the non-life insurance sector. It held that this
principle applies in areas such as compulsory insurance, e.g. insurance against civil liability in respect of
it stipulated that the public interest cannot be invoked for the
the use of motor vehicles. Moreover,
purpose of hindering the freedom to set rates.

Regarding the increases in rates that some Dutch insurance companies are charging policyholders living
outside the Netherlands, the insurance premium should be commensurate with the risk for which cover is
sought. It may be that Dutch insurance companies with policyholders living abroad consider this to be a
factor which increases the risk insured since the medical costs covered by the insurance policy would be
higher than in the Netherlands. In fact, management and administrative costs relating to insurance policies
for policyholders living abroad are generally higher than for domestic policyholders. Various factors, such
as agreements between health insurers, healthcare establishments and the medical profession in the
Netherlands, explain this difference in the costs incurred abroad by insurers. These agreements allow Dutch
insurers to keep the costs for policies covering risks located in the Netherlands at a level which enables
them to offer lower insurance premiums than they could offer for policies covering risks abroad, where
similar agreements with the medical profession do not exist. In other words, it would seem acceptable for
rates to continue to differ in so far as they are based on objective considerations.

In so far as health costs vary between Member States, insurance premiums should take this into account in
such a way as to adequately reflect the situation to be covered by the insurance policy. In addition, it must
be pointed out that, although the insurance premium may be higher if the policyholder does not live in

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3.4.2004

the Netherlands, he or she does not have to pay additional charges that account for a significant
proportion of the total price (premium and taxes). Such charges are levied on insurance policies for
policyholders living in the Netherlands.

As the Commission is not competent to supervise insurance companies, it is not in a position to inform
the Honourable Member whether this increase in rates for policyholders living abroad is intended
exclusively to compensate for the healthcare costs incurred by policyholders living in the United States.
The authorities in the Member States responsible for insurance supervision will be able to indicate whether
these increases in rates are intended to make all policyholders living abroad bear the costs relating to
policyholders living in the United States.

The Commission cannot intervene to demand that health insurance premiums should be the same amount
within the European Union and that rate increases should be permitted only when the circumstances in
the Member State concerned lead to a substantial rise in healthcare costs.

(1) ECR I-…

(2004/C 84 E/0200)

WRITTEN QUESTION E-0098/04

by Olivier Dupuis (NI) to the Commission

(22 January 2004)

Subject: Extradition of Sok Yoeun

On 28 November 2003, following proceedings that failed to comply with international standards, a Thai
appeal court ruled that 72-year-old Sok Yoeun must be extradited to Cambodia after a period of no fewer
than 15 days, but no more than three months. Sok Yoeun’s extradition was sought by those circles
wishing to show the existence of a plot to assassinate Hun Sen, in which Sam Rainsy, the Cambodian
opposition leader, is said to be involved.

The Office of the UN High Commissioner for Human Rights granted Mr Yoeun refugee status and the
Finnish authorities announced that they were prepared to grant him political asylum. The Thai judiciary’s
decision is extremely worrying in that it openly violates international law by setting a dangerous precedent
for anyone living under UNHCR protection in Thailand. The decision also serves to endorse the blatant
political machinations of Hun Sen’s party, and therefore to destabilise Cambodia.

Is the Commission aware of the latest developments in Sok Yoeun’s situation? If so, has it reacted officially
and in what way? What steps has it taken or does it intend to take, possibly together with the Finnish
authorities, to prevent Mr Yoeun’s extradition from Thailand to Phnom Penh? In addition, what initiatives
is the Commission considering in order to persuade the Thai authorities to revert to their previous practice
of respecting the international conventions to which Thailand is a party, particularly those concerning the
status of political refugees? What, more generally, is the Commission’s feeling about yet more political
scheming by certain well-known circles in Phnom Penh in an attempt
to destroy the democratic
opposition and, at the same time, hope of stronger democracy and rule of law in Cambodia?

Answer given by Mr Patten on behalf of the Commission

(19 February 2004)

The Commission, through its Delegations in Cambodia and in Thailand, together with the Member States’
representatives and with the United Nations High Commission for Refugees (UNHCR), has been following
developments in Mr Sok Yoeun’s case with the responsible government authorities.