Social Security/analysis : Healthcare Reimbursement, as Defined by the Treaty

Article excerpt

The patient and healthcare mobility dossier is closely linked to that on social security. In this area, the principal problem is not the freedom of movement (entry and residence in a member state, right to services, etc) as pointed out by the Court of Justice's Advocate General L. A. Geelhoed, rather "the conditions governing funding for such treatment", ie in practice social security issues. And yet, in this area the EU Treaty outlines very precise rules.

Social security is discussed on several occasions in the Treaty: as a Common Market objective, to permit certain bases for action, often limited but always carefully framed, and subject to certain limits. Thus the criteria for access to healthcare, the organisation and structure of social security and funding remain an expressly national responsibility.

Article 2 (Objectives) of the EC Treaty assigns the Common Market, economic and monetary union and (EU) common policies the objective of "promoting[...] a high level of social protection".


Article 42 (free movement of workers) provides a legal basis "in the field of social security"for making arrangements "to secure for migrant workers and their dependants: (a) aggregation, for the purpose of acquiring and retaining the right to benefit and of calculating the amount of benefit, of all periods taken into account under the laws of the several countries; (b) payment of benefits to persons resident in the territories of member states". The various rules on cross-border reimbursement for healthcare are based on this article (co-decision, unanimity).

Article 137 (social policy) stipulates that the "Community shall support and complement the activities of the member states" in the field of "social security and social protection of workers", as well as in the improvement and harmonisation of the social protection systems. …