Chapter 2

5.4 - Mobility of italian patients within
European Union
Donia Sofio A., Gabellini A.
5.4.1 Reasons for patient mobility
The phenomenon of patient mobility within European Union has been only lately
analysed. Till recent years, the countries belonging to EU have operated individually
only on the basis of national rules.
This was mainly due to two reasons: first of all the NHSs granted access to health services
only to people living on their own EU country territory. Secondly, health care has
not been involved in community policies for many decades. Only in 1993 with
Maastricht Treaty, the European Commission has played a complementary role on the
ground of health services, however within the limits of comma 5 in art. 152 according
to which “the arrangement and supply of health services” pertain exclusively to each
EU member State.
In the last decades, though, many structural changes, both political and economical,
have occurred in Europe, and they have put under pressure the whole arrangement of
health care supply within the EU member States (progressive ageing of population,
development of new technologies, increase in management costs, strict macroeconomic
constraints which reduce the financial affordability of each NHS).
In such a context, other factors have boosted the reasons for patient mobility, mainly
due to the obvious desire of each patient to look for the best and cheapest health care
provided as early as possible.
The first of the factors responsible for patient mobility is the people mobility within the
EU, for job/study reasons or simply for touring around. In that the EU Court has played
a very important role with issuing Bills 1 regulating service supply, including health
care, with recognizing that, within the EU and under certain conditions, the State of
origin will be charged for the cost of health care provided to citizens coming from
other EU countries; finally the multiplying effect brought about by the new information
technologies has offered an easy way to obtain and exchange news on the best international
health care providers.
As a result five different categories of “mobile” patients can be detected according to
the reason for their mobility:
• tourists who need health care while they are visiting one of EU countries;
1 The most important ones have been those ruling the cases Decker (1995), Kholl (1996), Vanbraekel (1998), Geraets-
Smits/Peerbooms (1999).
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CEIS Health Report 2006