1. Cross-border Healthcare in Sweden and establishment of national contact points Thomas Zilling MD, PhD Vice President of the AEMH 22 November 2013

2. The Cross-border Healthcare directive 2011/24/EU came into force in Sweden October 1 st 2013 Implementation of the Cross- border healthcare Directive in Sweden

3. Financing of healthcare in Sweden 21 County councils are allowed to tax the local population and are responsible to provide healthcare for the inhabitants

4. Implementation of the Cross-border healthcare Directive in Sweden  Swedish patients are reimbursed for planned medical care in the EU/EES if:  - the care has been provided by licensed medical staff  - the costs should have been covered by public funds if the medical care had been given in Sweden

5. Implementation of the Cross-border healthcare Directive in Sweden  Patients should not be denied the right to compensation solely on the basis that the treatment is not used in Sweden, as long as the treatment is based on “international medical science and generally recognised good medical practice”.  The patient’s home county council is responsible for covering the costs.

6. A small but increasing number of Swedes go abroad for medical care Number of Swedish applicants that recieved grants for medical care in another EU country, according to to the EC treaty.

7. Top recieving countries, 2012 Denmark 63% Finland 16% Spain 8% Norway 6% Other EU/EES 16%

8. Main types of medical care (2012) The most typical patient in 2012 lived in the south of Sweden and went to neighbouring Denmark for cataract surgery due to long waiting lists in the county council. It was also quite common for patients with psoriasis or other dermatological diseases to go abroad for climate treatment in Spain and other countries in southern Europe.

9. Two national contact points 1. The National Board of Health and Welfare. National contact point for EU citizens seeking medical care in Sweden. 2. The Swedish Social Insurance Agency. National contact point for Swedish citizens seeking care in another EU country.

10. 1. www.socialstyrelsen.se/healthcare-visitors-sweden

11. Responsibilities accordning to Government commissions  Information about standards and guidelines for quality and safety in the Swedish healthcare system  General information about accessibility for the disabled  Information about healthcare providers, on demand also about specific providers licenses to practice  Information about patients’ rights, how to make complaints and conditions for financial compensation for medical injuries.

12. 2. www.forsakringskassan.se/privpers/utomlands

13. Responsibilities accordning to Government commissions  Information about patients’ rights in cross- border healthcare  Information about conditions for prior authorization, ”advance notice” and subsequent reimbursement  Application forms

14. Questions for the future  How to define; “international medical science and generally recognized good medical practice”.  Will this open a new market for medical tourism?

15. Thanks