title: 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.
authors: Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health, Poland. Electronic address: iw.kowalska@uj.edu.pl.
authors: Iwona
authors: I
authors: Kowalska-Bobko
authors: Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health, Poland.
authors: Anna
authors: A
authors: Mokrzycka
authors: European Observatory on Health Systems and Policies, United Kingdom.
authors: Anna
authors: A
authors: Sagan
authors: Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health, Poland.
authors: W Cezary
authors: WC
authors: Włodarczyk
authors: Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health, Poland.
authors: Michał
authors: M
authors: Zabdyr-Jamróz
mesh_terms: D004641:Emigration and Immigration; D015276:Health Care Rationing / Q000379:methods; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D057193:Medical Tourism / Q000331:legislation & jurisprudence*; D028701:Patient Rights / Q000331:legislation & jurisprudence; D011044:Poland
keywords: Cross-border health care; Directive 2011/24/EU; Europe; Health care rationing; Health care reform; Health policy; International law; Patients’ right; Treatment abroad