92001E2425

WRITTEN QUESTION E-2425/01

by Erik Meijer (GUE/NGL) to the Commission

(4 September 2001)

Subject: Categories of residents that are difficult to insure because of exclusion clauses applied by sickness insurance schemes

Since 1998 private sickness insurance schemes in the Netherlands have been required to provide cover for all applicants. This means that persons living in the Netherlands must be accepted on the basis of a standard package, subject to certain conditions.

Since 1971 workers have been covered by a European Regulation under which those who migrate to other Member States are entitled to access to a sickness insurance scheme on the same terms as residents of the country concerned (Regulation (EEC) 1408/71(1)).

There are no such rules for individuals who go and live in another Member States and have to rely on a private sickness insurance scheme. Consequently, they often find themselves subject to exclusion clauses whereby, for example, the insurers exclude future risks on the basis of medical history. Exclusions frequently involve risks that citizens cannot afford because of extremely expensive new treatments.

1. Is the Commission aware of this situation?

2. Does the Commission share the view that any citizen who settles in another Member State of the European Union is in principle entitled to medical care of an acceptable minimum level and that there should be no question of exclusion clauses?

3. How many people fall into the category that is at risk of being partially uninsured owing to the absence of a duty on private insurers to provide cover?

4. Does the Commission have an overview of the situation in different European countries? If not, is prepared to draw up an inventory? If so, will it make this information available?

5. Is the Commission drafting proposals to ensure that no group of residents of the Member States of the EU, irrespective of income, occupation or nationality, can in future be refused standard sickness insurance? If not, why is the Commission postponing or refraining from introducing such measures?

(1) OJ L 149, 5.7.1971, p. 2.

Answer given by Mrs Diamantopoulou on behalf of the Commission

(25 October 2001)

1. and 2. The questions raised by the Honourable Member are in line with the concerns already set out by the European Parliament in its own-initiative report on supplementary health insurance(1), which was adopted on 15 November 2000. This report provided an analysis of supplementary health insurance schemes and rightly emphasised that state or statutory health insurance schemes, which are covered by Regulation (EEC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community(2), provide very broad healthcare cover in the majority of Member States. The report rightly discussed the role which these supplementary health insurance schemes might nevertheless play in access to healthcare and raised in particular the question of the obstacles to free movement of persons and services in another Member State which can result from the very significant differences between systems.

3. and 4. The Commission welcomed the parliamentary initiative and has undertaken to draw up an in-depth report of the situation in order to gain a better understanding of the diversity and intrinsic complexity of the various schemes. A study of supplementary health insurance schemes within the Community was therefore begun and is currently under way.

5. The results of the study are expected in December 2001 and will be published at the beginning of 2002. They will be used as a basis for all other Commission initiatives in this area and will in particular help to give rise to a debate with all other parties involved.

(1) 2000/2009 (INI) PE 286.239.

(2) OJ L 149, 5.7.1971.