UVELJAVLJANJE PRAVIC PACIENTOV NA PODROČJU ČEZMEJNEGA ZDRAVSTVENEGA VARSTVA

• Main Author: Lešnik, Ana
• Other Authors: Kraljić, Suzana
• Format: Bachelor Thesis
• Language: Slovenian
• Published: A. Lešnik 2009
• Subjects: pravice pacientov; čezmejno zdravstveno varstvo; zdravstveno zavarovanje; Evropska unija; Evropska kartica zdravstvenega zavarovanja; prost pretok storitev in dajatev; Patients rights; cross-border healthcare; health insurance; European Union; the European Health Insurance Card; free flow of services and duty; info:eu-repo/classification/udc/34(043.2); Norway; Iceland
• Online Access: https://dk.um.si/IzpisGradiva.php?id=12435; https://dk.um.si/Dokument.php?id=11903&dn=; https://plus.si.cobiss.net/opac7/bib/4003883?lang=sl

Pravica do zdravljenja v drugi državi članici je pravica posameznika, ki omogoča zdravstveno varstvo tudi zunaj meja domače države. V diplomski nalogi sta predstavljeni dve pravici iz sistema čezmejnega zdravstvenega varstva. Kot prva je predstavljena pravica do potrebnega zdravljenja v drugi državi članici, ki jo zavarovanec lahko uveljavlja na podlagi Evropske kartice zdravstvenega zavarovanja. Omenjena kartica omogoča ljudem iz držav članic Evropske unije (EU) ter iz Islandije, Hrvaške, Lihtenštajna, Norveške in Švice lažji dostop do zdravstvenih storitev med začasnim bivanjem v tujini. Največ pozornosti je namenjeno pravici do načrtnega zdravljenja v drugi državi članici. Za uveljavljanje pravice obstajata dva vzporedna sistema, ki omogočata mobilnost pacientov med državami članicami EU. Osnovni sistem predstavlja 22. člen Uredbe št. 1408/71 o uporabi sistemov socialne varnosti za zaposlene osebe, samozaposlene in njihove družinske člane, ki se gibljejo znotraj Skupnosti, ki postavlja pogoj pridobitve predhodnega dovoljenja od nacionalnega nosilca zdravstvenega zavarovanja. Vzporedno pa Sodišče Evropske skupnosti (Sodišče ES) v svojih sodbah razlaga določbe Pogodbe o ustanovitvi evropske skupnosti in možnost prostega pretoka zdravstvenih storitev in dajatev med državami članicami neposredno na PES. V okviru načrtnega zdravljenja v drugi državi članici je prav tako mogoče zaznati povečano zanimanje ljudi za tako imenovani zdravstveni turizem. V nadaljevanju so navedene novosti, ki jih bo prinesla Uredba št. 883/04 o koordinaciji sistemov socialne varnosti in predlog Direktive o uveljavljanju pravic pacientov na področju čezmejnega zdravstvenega varstva. Ob konecu je predstavljena še trenutna zakonska ureditev čezmejnega zdravstvenega varstva v Sloveniji in postopek pridobitve dovoljenja za zdravljenje v drugi državi članici, ki se sproži na Zavodu za zdravstveno zavarovanje Slovenije. The right to cross-border healthcare inside the EU is the right of an individual, which allows him a proper healthcare also outside his home country. In this diploma thesis two rights from the system of cross-border healthcare are presented. First the right to the necessary health treatment in another Member State is presented, which may be claimed on the basis of the European Health Insurance Card. This card allows all citizens of the Member States of the European Union and citizens of Iceland, Croatia, Liechenstein, Norway and Switzerland an easier access to health services during their stay abroad. The most attention was given to the right of systematic treatment in another Member State. To exercise this right, there are two parallel systems, which enable the mobility of patients between EU Member States. The basic system is presented through a 22nd Article of Regulation No. 1408/71 on the application of social security schemes to employed and self-employed persons and to members of their families moving within the Community which present a condition for obtaining a prior permission from national institution of health insurance. In parallel, the judgments of European Court of Justice (ECJ EC) interpret the provisions of the Treaty establishing the European Community and the possibility of free flow of health services and duties between Member States directly to the TEC. In the frame of systematic treatment in another Member State it is also possible to detect the increased interest of people for so-called medical Tourism. Next the innovations which result from the Regulation No. 883/04 on coordination of social security and the proposal for a directive on the enforcement of patients rights in cross-border healthcare are stated. At the end the current regulations of cross-border healthcare in Slovenia and the process of obtaining a permition for treatment in another Member State, which is activated by Health Insurance Institute of Slovenia, are described.