Implementation of the cross-border healthcare directive in Poland: How not to encourage patients to seek care abroad?

Abstract

In October 2014, after over 12 months of delay, Poland finally implemented directive 2011/24/EU on the application of patients' rights in cross-border healthcare. The implementing legislation in the area of cost reimbursement and prior authorization is very restrictive. The goal is to either defer the public payer's expenses into the future or to discourage patients from seeking care abroad or from seeking care altogether. The Polish government and the Ministry of Health, the key stakeholders in the implementation process, seemed to overlook the potential monetary benefits that the implementation of the directive could bring, for example, by promoting Poland as a destination for health tourism. Other stakeholders, such as patients and healthcare providers, had no real influence on the policy process. So far, the number of applications for planned treatment abroad has been very low and the majority of them were actually turned down as they did not meet the formal requirements. This number is likely to remain low in the future as accessing such care is cumbersome and not affordable for many patients. Overall, while the directive does not aim to encourage patients to seek cross-border healthcare, the current national regulations in Poland do not seem to facilitate access to cross-border healthcare, which is the main goal of the directive.

Cross-border healthcare: A review and applicability to North America during COVID-19

“…In fact, during the development of the EU agreement, Portugal, Romania, Poland, and Austria all voted against cross-border healthcare. [13] , [15] There were several challenges with this agreement from a healthcare provider perspective. A frequently cited issue was the difficulty of transfer of patient information leading to the need for an interoperable electronic medical record (EMR).…”

“…They argued that their healthcare systems would lose money along with a significant number of healthcare practitioners, a result of their citizens seeking care elsewhere. [13] , [15] They anticipated a situation of unsustainable healthcare funding, which would divert resources away from their own practitioners. [13] The enactment of the EJC rulings came at a time of financial difficulty and uncertainty, in addition to the concerns voiced by some countries.…”

“…It would be reasonable to anticipate that issues similar to those voiced by EU member-states opposed to cross-border healthcare (such as Poland), could arise in the context of the US-Mexico border. [13] , [14] , [15] One of these anticipated issues could be the costs associated with an exodus of patients leaving Mexico to seek healthcare in the US. However, similar to the EU experience, current evidence suggests that the majority of first generation Mexican patients living in America seek healthcare in Mexico.…”

“…[8] , [12] Initial efforts by the European Court of Justice (ECJ) worked to create a cross-border system, which largely eliminated the requirement of prior authorization; however, the economic concerns of many EU countries led to this ultimately never being enacted. [13] , [14] , [15] …”

Destination Management Organizations and Health Tourism Visual Identification in Central and Eastern Europe

“…Also, one should not forget about the great significance of legislative solutions (Kowalska-Bobko et al, 2016;Polyzos et al, 2008). Marketing undertakings play a significant role in these actions.…”