Shopping for EU health care no free ticket

Shopping for EU health care no free ticket
Residents of Sweden will soon have more access to health care across the EU than before, but the new law does not pave the way for unlimited nor completely free cross-border treatments, experts warn.

Currently, overly-long queues for certain procedures means Sweden steps in and picks up the tab if a patient decides to go elsewhere in the European Union. This autumn, however, the system is set to change, not only giving patients more choice on paper regarding what treatment to seek abroad, but also transferring the decision-making process to the regional level.

“The consultation will, among other things, look at what financial compensation the patient will get,” Hasse Knutsson, planning officer at the Swedish Association of Local Authorities and Regions (Sveriges kommuner och landsting – SKL), told The Local.

While Swedish counties normally pick up the tab for health care, the state has administered and paid for health care purchased in other EU countries. But that system is set to change on October 1st, although the state has promised to earmark funds in the autumn budget for the counties to dip into to ease the transition.

The decision of who gets what from whom, however, will transfer over to the counties, which will confer in reviewing patient applications with the National Insurance Agency (Försäkringskassan).

At SKL, Knutsson underlined that while patients can apply retroactively to have their treatment or operation paid for by Swedish authorities, there is never a guarantee that the full cost will be reimbursed.

“Say for example that replacing a hip costs 55,000 kronor ($8,400) in Sweden, but you get it done in Germany where the price is 70,000. The guideline is the Swedish price,” he said.

The Dagens Nyheter (DN) newspaper reported on Monday that last year some 3,000 Swedes got money back for health care obtained abroad, but about 400 people who applied for coverage were rejected. The final tab for 2012 came in at 58 million kronor ($8.9 million).

Swedish patients most commonly seek help with skin conditions and eye problems, records reveal, but there are signs that ailments that Swedish health care have little capacity to treat are pushing patients over the borders – for example, injections against heavy sweating.

Will patients looking for specialized treatment mean hospitals across Europe become more and more specialized?

“It is difficult to speculate about what effects this reform will have, both in terms of the number of people leaving for treatment and people coming here,” SKL planning officer Hasse Knutsson said.

With specialized hospitals potentially picking up more clients from abroad, could the Swedish health care system become more vulnerable to fluctuations in the global economy? A waxing-and-waning customer base presents no easy challenge for budget planning.

“If you want to see it from a financial perspective, you should not forget that there may be more patients coming here,” Knutsson said. “But it’s difficult to offer a prognosis.”

The threat of patients snubbing local health care in Sweden could also, those optimistic about the reform said this week, have a positive effect on patient services at home in Sweden.

“Hopefully, the counties will give patients the care they want at home, because it will be more expensive for the counties to finance it being done abroad, ” health ministry spokeswoman Maria Nilsson told DN.

Ann Törnkvist

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