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With more and more people traveling within the EU,

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what happens if a European citizen needs health care in another member state?

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And especially, what about the cost?

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The European Health Insurance Card covers the costs if you fall ill during a trip to another EU country.

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Costs are also covered for patients who have been authorized by their national health system

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to go to another member state for medical treatment.

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But what happens if the authorization is not granted?

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Let's consider the case of Yvonne Watts.

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This resident of Bedford suffered from arthritis in both hips.

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She would have had to wait a year for an operation in the United Kingdom.

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Wracked by unbearable pain, she could wait no longer.

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Despite the refusal of her health authorities, she traveled to France,

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where her operation could be provided sooner.

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When she returned, her claim for reimbursement of her medical expenses was refused.

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After several appeals in British courts, her case went to the Court of Justice of the European Communities,

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which decided in favor of free circulation, reflecting the principle of patient mobility.

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Following this jurisprudence, the European Commission is acting to clarify

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the right of European citizens to cross-border health care.

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Patients want to have health care as close to home and as quickly as possible.

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But sometimes the best way to provide that health care may be in another member state.

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It may be that you live in a border region,

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where the nearest hospital is just across the border in another country.

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Or it may be that the care that you need is so specialized

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that actually it's not available in your own member state and needs to be provided elsewhere.

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The aim of this initiative is to make it easier for patients to have the health care that they need,

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wherever it can best be provided within the European Union.

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Another example illustrates the issues from free movement in the health sector.

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Nicolas Decker, who lives in Luxembourg, needed a new pair of eyeglasses.

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He took the prescription he received from his Luxembourg practitioner

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and went to Arlon in Belgium to purchase his glasses from a Belgian optician.

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Then I sent the bill to my medical insurance company in Luxembourg,

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which, to my great astonishment, refused to pay.

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They justified their refusal, stating that I should have requested prior authorization.

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Now, in my mind, this constitutes a barrier to the free movement of goods throughout the Union.

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Thus, in 1992, I launched a long series of legal proceedings.

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And the case was finally judged by the European Court of Justice,

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which, by an order in April 1998, decided in my favor.

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The principle is thus acquired, but do all European citizens have this right?

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The question, though, is exactly how can those rights be used in practice?

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At the moment, there is a lot of uncertainty for patients, for health professionals,

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and for people who are responsible for health systems about what community law means

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for cross-border provision of health services.

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This initiative is intended to address that uncertainty

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and to provide a clear framework for patients to be able to have access to health care in other Member States

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and for Member States themselves to be able to regulate and plan their systems effectively.

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The principle of patient mobility is crucial in the case of patients suffering from rare diseases.

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Hansel Schlucht lives in Nancy, in France. He suffers from Gorham disease.

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This vascular disorder hinders bone mineralization and can lead to paraplegia.

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After considerable research, the family consulted American specialists who defined a treatment protocol.

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There was a problem, however. The American treatment is not authorized in France.

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The American treatment consists of two medications.

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One must be taken every day, and in France this treatment is not authorized on a daily basis

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in the dosage that the American doctors prescribed.

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Monique Schlucht thus looked elsewhere in Europe and found a solution in Spain.

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In Madrid, Dr. López accepted to take Hansel's case

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and to apply the protocol defined by the American specialists.

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Hansel has been treated for the past eight months with this American protocol

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based on anti-anxiety drugs intended to slow down lymphatic proliferation in the bones.

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We hope this protocol will improve over time,

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that the disease will go into regression,

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and that we may even be able to envisage reconstructive surgery,

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especially to the spine, which is Hansel's most seriously damaged organ.

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In the case of Gorham disease, like other rare diseases,

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why is it so hard to find treatment closer to home?

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There are many factors involved.

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The first is that it's hard to find a doctor with experience in this disease.

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In fact, there aren't many, even all over Europe.

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Then you need to find a doctor willing to take on a chronic patient requiring a lot of care

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and who is backed by a multidisciplinary team of specialists.

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Just one doctor alone can't manage.

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As health care becomes more specialized and more expensive,

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it can be difficult for every member state to afford to have every type of specialized care.

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By making it easier for systems to cooperate with each other,

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we can help all health systems to be able to provide the best care possible.

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But what about the costs of this treatment?

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In principle, the French social security should be able to take on the cost of treatment in Spain.

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The American protocol is a fairly costly treatment,

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and the cost of treatment in Spain is very high.

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The cost of treatment in Spain is very high,

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and the cost of treatment in Spain is very high.

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The cost of treatment in Spain is very high,

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and the cost of treatment in Spain is very high,

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and our problem was that the social security in France didn't want to bear the cost of the treatment,

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considering that in the long term, this treatment could have been given in France.

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But for this type of disease, it's the short term that counts.

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When Dr. Lopez agreed to treat Hansel, the decision was swift.

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Hansel changed countries and moved in with his sister who lives and works in Barcelona.

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The Spanish social security could thus cover part of the treatment.

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The issue is that they sometimes find it difficult

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to then have the reimbursement for that health care that they're entitled to.

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This initiative will aim to provide additional clarity

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to make it clearer for patients as to what health care they're entitled to

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and how they can be reimbursed for it,

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and clearer also for health system managers

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who need to plan and regulate their own systems

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to be able to provide health care not just to patients who move,

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but patients who stay within their own member state.

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The Charter of Fundamental Rights of the European Union

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includes the right to health care for all.

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However, it's up to member states to decide how to implement this in practice.

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This initiative respects that responsibility of the member states

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and is not intended to harmonize health care systems.

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It will also complement the existing coordination of national health care systems.

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Rather, the objective of European action is to help ensure

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that all European patients have access to safe, high-quality health care

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within a reasonable time,

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and that they know how the costs of that care will be covered.