1. Free Delivery of Healthcare Services in Europe Some ideas based on an article published by the Association Internationale de la Mutualité in European Public Health Update, May-June 2002. Hervé Doaré EHTEL Association

2. p2 Cross-Border Patient Flow: a summary % of Total Healthcare expenditures in EU based on E125 and E127 19890.17 % 19930.30 % 19970.50 % Report of the High Level Committee on Health. December 2002

3. p3 Transborder cooperation ENSP 2002

4. p4 Decisions of the Court of Justice of Luxembourg Kohl & Decker: 1998 Smit and Decker: July 2001 Vanbraeckel: July 2001 « made it easier for patients to be reimbursed for non emergency treatment in another Member State » ( AIM)

5. p5 A Free Market? The Analysis of AIM Not Yet –Linguistic and cultural barriers –Lack of comprehensive information –Some confusion: the decisions of the Court of Justice are not interpreted in the same way by the Member States.

6. p6 A Free Market? The Analysis of AIM (part 2) Expected Development –transborder contracting between insurers and HC Providers due to the increasing lack of HC Resources –Less restricted authorisation policies by the Member States –Increased information for patients on HC Suppliers across borders

7. p7 A Free Market? The Analysis of EHTEL But the door is open: –European Market of Healthcare Services ( incl e-health) –Free Movement of Patients in Europe Future in the hands of –Patients: Waiting lists, better healthcare, less expensive –Healthcare Insurance Institutions: encouragement for Modernisation Competition Openness towards European issues

8. p8 A Free Market? The Analysis of EHTEL (part 2) The members of EHTEL believe that eHealth solutions (Health Telematics) are a good tool to be used in this process of evolution for the benefits of all healthcare actors (Patients, Heathcare Professionals, Healthcare Insurers...)