<abstract xmlns="http://www.w3.org/1999/xhtml"><p> This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken to provide a financial incentive but may also involve payment risks and administrative burden. For the pathways given by the Social Security Regulations (883/2004 and 987/2009) and the EU Directive 2011/24/EU, we investigate how the associated financial arrangements act on providers, patients and on publicly funded health insurance. First, the Regulations can induce cross-border health care that will increase domestic health care expenditure and may threaten national health policy by setting an incentive for patients to go abroad for health care not covered by domestic health insurance. Second, the financial arrangement of the Directive may induce cross-border health care which will lower domestic health care expenditure. However, due to considerable payment risks and administrative burden on both patients and providers, these benefits will not be reaped in full. Moreover, in the presence of national cost containment policies, the Directive may provide an incentive for cross-border health care that is too strong. Finally, due to the requirement to pay upfront, the financial arrangement also suffers from a lack of equity of access to health care provision abroad.</p></abstract>

This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken to provide a financial incentive but may also involve payment risks and administrative burden. For the pathways given by the Social Security Regulations (883/2004 and 987/2009) and the EU Directive 2011/24/EU, we investigate how the associated financial arrangements act on providers, patients and on publicly funded health insurance. First, the Regulations can induce cross-border health care that will increase domestic health care expenditure and may threaten national health policy by setting an incentive for patients to go abroad for health care not covered by domestic health insurance. Second, the financial arrangement of the Directive may induce cross-border health care which will lower domestic health care expenditure. However, due to considerable payment risks and administrative burden on both patients and providers, these benefits will not be reaped in full. Moreover, in the presence of national cost containment policies, the Directive may provide an incentive for cross-border health care that is too strong. Finally, due to the requirement to pay upfront, the financial arrangement also suffers from a lack of equity of access to health care provision abroad.

Cross-Border Health Care in the European Union: Evaluation of Different Financing Arrangements

Engineering Management in Production and Services

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken...

Cross-Border Health Care in the European Union: Evaluation of Different Financing Arrangements

Published Online: Jun 23, 2017

Page range: 8 - 20

Received: Jan 15, 2017

Accepted: Jun 10, 2017

DOI: https://doi.org/10.1515/emj-2017-0009

Keywords
financing arrangement, cross-border health care, national health policy

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Cross-Border Health Care in the European Union: Evaluation of Different Financing Arrangements

Published Online: Jun 23, 2017

Page range: 8 - 20

Received: Jan 15, 2017

Accepted: Jun 10, 2017

DOI: https://doi.org/10.1515/emj-2017-0009

Keywordsfinancing arrangement, cross-border health care, national health policy

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
financing arrangement, cross-border health care, national health policy