The development of standardised medical healthcare protocols and delivery standards is happening anyway, but could be promoted by the EU by way common codes of practice etc. Countries with long waiting lists for essential Breast Cancer treatment services , for example, could be required to enable their citizens receive treatment abroad, and reimburse the service providing nation for the cost.
Which brings me the the third and most difficult area: the funding and management of such services. Different, public, private, for profit, and non-profit private models apply to varying degrees in different member states. Perhaps the EU could make a start by agreeing a standard pricing structure for standard procedures and treatment protocols which could form the basis for inter-state financial transfers where a patient entitled to receive a service in one member state, actually receives that treatment in another.
No doubt there would be rows about what prices should apply, who is entitled to give/receive specific services, and to what extent "competition" should be allowed between service providers. There is scope for a degree of regulated diversity between member states.
But what the EU should do is at least agree common entitlements and minimal treatment processes/protocols so that the debate can shift to the best way of delivering such services on a trans-national basis. It may well be that one member state has a surplus of treatment capacity in one area, and shortage in another, so a truly transnational system could deliver better health outcomes for the same overall cost by optimising capacity utilisation across borders.
If the EU really is to win the hearts and minds of its citizens, it has to move beyond internal markets and corporate governance into areas which really matter to citizens in their daily lives. And health care comes pretty close to the top of the list of core issues for all citizens. notes from no w here
The sticky point here is that 1) and 3) are interconnected. The choice of compensation scheme is not treatment-neutral and the choice of patient rights scheme is certainly not neutral w.r.t. the choice of compensation scheme.
The risks here are first that 1) and 3) are negotiated separately and that the solutions that are agreed upon create some unintended interference effect that is not obvious when each is considered in isolation. And second, that the issue will be treated as a federal trade issue, not as a federal health and infrastructure issue. The infrastructure people in the EU are reasonably sane. The trade people are, frankly, batshit crazy.
- Jake If you only spend 20 minutes of the rest of your life on economics, go spend them here.
The issue of how those entitlements are met through service delivery, and how those services are managed and funded should be entirely separate and can allow for some regional/national variation. For instance the UK might deliver all public services through the NHS whereas in Ireland some might be delivered through public hospitals, and others by private hospitals under contract to the state to deliver certain services at standard prices.
I'm sure we all have our favourite models (mine is all public), but there are huge ideological issues here which would preclude progress any time soon if we tried to impose one model.
So why not focus on the EU defining entitlements and standard treatment protocols and prices, and let member states decide how best to manage the delivery of those services at standard prices? notes from no w here
What I'm afraid of is that the list of patient rights will be implemented, but no transfer scheme will be set up that enables the provider to bill somebody and be sure to get his money. And then you're essentially billing the good guys, because they take patients in without first checking whether they get paid for them, whereas the bad guys tell them to sod off if there's no money on the barrelhead.
And, of course, there's the perennial risk that a partial list of health care rights will be used as an excuse to underfund other health care provision ("well, Bruxelles says that we have to pay this sum of money to a French hospital, so that comes out of your budget..."). But I count that as a problem with a state-level democratic deficit, rather than a problem at the federal level.
