European Universal Healthcare Act
Montenbourg last edited by
Granger steps up and present the bill towards the council.
Dear Councillors, its time.
I am very proud of the fundamental role the EU, Member States, and European civil society played in the creation and promotion of quality healthcare in our countries. We are all committed to meeting these targets. But achieving universal health requires more than verbal commitment. It depends on strategic and sustained co-operation by all major stakeholders – and it requires reaching the most vulnerable groups in our societies.It requires the push of an act that protects this Human Right.
Europeans need a health care system that works for patients and providers. We need to focus our regional investments on training the health care providers. We need to ensure a strong health care workforce in all communities now and in the future. We need to build on the strength of the 50 years of success of our Healthcare programs. We need a health care system that significantly reduces overhead, administrative costs and complexity. We need a system where all people can get the care they need to maintain and improve their health when they need it regardless of income, age or socioeconomic status. We need a system that works not just for millionaires and billionaires, but for all of us.
Here is our European Universal Healthcare Act
I-ESTABLISHMENT OF THE UNIVERSAL EUROPEAN HEALTHCARE PROGRAM.
There is hereby established a European health insurance program to provide comprehensive protection against the costs of health care and health-related services, in accordance with the standards specified in, or established under, this Act.
SEC. 102. UNIVERSAL ENTITLEMENT.
(a) In General.—Every individual who is a resident of the European Union is entitled to benefits for health care services under this Act. The Speaker shall promulgate a rule that provides criteria for determining residency for eligibility purposes under this Act.
(b) Treatment Of Other Individuals.—The Speaker may make eligible for benefits for health care services under this Act other individuals not described in subsection (a), and regulate the nature of eligibility of such individuals, while inhibiting travel and immigration to the European Union for the sole purpose of obtaining health care services.
SEC. 103. FREEDOM OF CHOICE.
Any individual entitled to benefits under this Act may obtain health services from any institution, agency, or individual qualified to participate under this Act.
SEC. 104. NON-DISCRIMINATION.
(a) In General.—No person shall, on the basis of race, color, national origin, age, disability, or sex, including sex stereotyping, gender identity, sexual orientation, and pregnancy and related medical conditions (including termination of pregnancy), be excluded from participation in, be denied the benefits of, or be subjected to discrimination or any entity conducting, administering, or funding a health program or activity, including contracts of insurance, pursuant to this Act.
(b) Claims Of Discrimination.—
(1) IN GENERAL.—The Speaker shall establish a procedure for adjudication of administrative complaints alleging a violation of subsection (a).
(2) JURISDICTION.—Any person aggrieved by a violation of subsection (a) by a covered entity may file suit in the European Court of Justice .
(3) DAMAGES.—If the court finds a violation of subsection (a), the court may grant compensatory and punitive damages, declaratory relief, injunctive relief, attorneys’ fees and costs, or other relief as appropriate.
SEC. 105. ENROLLMENT.
(a) In General.—The Member States shall provide a mechanism for the enrollment of individuals eligible for benefits under this Act. The mechanism shall—
(1) include a process for the automatic enrollment of individuals at the time of birth in the European Union and at the time of immigration into the European Union or other acquisition of qualified resident status in the European Union;
(2) provide for the enrollment, of all individuals who are eligible to be enrolled
(3) include a process for the enrollment of individuals made eligible for health care
(b) Issuance Of Healthcare European Cards.—In conjunction with an individual’s enrollment for benefits under this Act, the Secretary shall provide for the issuance of a Healthcare Cards card that shall be used for purposes of identification and processing of claims for benefits under this program.
SEC. 106. EFFECTIVE DATE OF BENEFITS.
(a) In General.—Except as provided in subsection (b), benefits shall first be available under this Act for items and services furnished on January 1 of the fourth calendar year that begins after the date of enactment of this Act.
(b) Coverage For Children.—
(1) IN GENERAL.—For any eligible individual who has not yet attained the age of 22, benefits shall first be available under this Act for items and services furnished on January 1 of the first calendar year that begins after the date of enactment of this Act.
(2) OPTION TO CONTINUE IN OTHER COVERAGE DURING TRANSITION PERIOD.—Any person who is eligible to receive benefits as described in paragraph (1) may opt to maintain any coverage, private health insurance coverage, or coverage offered pursuant until the effective date described in subsection (a).
II. SEC. 201. COMPREHENSIVE BENEFITS.
(a) In General.— individuals enrolled for benefits under this Act are entitled to have payment made by the Secretary to an eligible provider for the following items and services if medically necessary or appropriate for the maintenance of health or for the diagnosis, treatment, or rehabilitation of a health condition:
(1) Hospital services, including inpatient and outpatient hospital care, including 24-hour-a-day emergency services and inpatient prescription drugs.
(2) Ambulatory patient services.
(3) Primary and preventive services, including chronic disease management.
(4) Prescription drugs, medical devices, biological products, including outpatient prescription drugs, medical devices, and biological products.
(5) Mental health and substance abuse treatment services, including inpatient care.
(6) Laboratory and diagnostic services.
(7) Comprehensive reproductive, maternity, and newborn care.
(9) Oral health, audiology, and vision services.
(10) Short-term rehabilitative and habilitative services and devices.
(b) Revision And Adjustment.—The Speaker shall, on a regular basis, evaluate whether the benefits package should be improved or adjusted to promote the health of beneficiaries, account for changes in medical practice or new information from medical research, or respond to other relevant developments in health science, and shall make recommendations to the Council regarding any such improvements or adjustments.
(c) Complementary And Integrative Medicine.—
(1) IN GENERAL.—In carrying out subsection (b), the Speaker shall consult with the persons described in paragraph (1) with respect to—
(A) identifying specific complementary and integrative medicine practices that, on the basis of research findings or promising clinical interventions, are appropriate to include in the benefits package; and
(B) identifying barriers to the effective provision and integration of such practices into the delivery of health care, and identifying mechanisms for overcoming such barriers.
States May Provide Additional Benefits.—Individual States may provide additional benefits for the residents of such States at the expense of the State.
SEC. 202. NO COST-SHARING.
(a) In General.—The Speaker shall ensure that no cost-sharing, including deductibles, coinsurance, copayments, or similar charges, be imposed on an individual for any benefits provided under this Act, except as described in subsection (b).
(i) such cost-sharing does not exceed $200 annually per individual, adjusted annually for inflation; and
(ii) under which the Speaker may exempt brand-name drugs from consideration in determining whether an individual has reached any out-of-pocket limit if a generic version of such drug is available.
(c) No Balance Billing.—Notwithstanding contracts in accordance with section 303, no provider may impose a charge to an enrolled individual for covered services for which benefits are provided under this Act.
SEC. 204. COVERAGE OF LONG-TERM CARE SERVICES .
“(1) a State plan for medical assistance shall provide for making medical assistance available for services that are long-term care services (as defined in subsection (b)) in a manner consistent with this section; and
“(2) no payment to a State shall be made under this title with respect to expenditures incurred by the State in providing medical assistance after such date for services that are not long-term care services.
“(b) Long-Term Care Services Defined.—In this section, the term ‘long-term care services’ means the following:
“(1) Nursing facility services for individuals 21 years of age or over.
“(2) Home health services.
“(3) Nursing services.
“(4) Rehabilitative services.
“(5) Inpatient services for individuals 65 years of age or over provided in an institution for mental disease.
“(6) Intermediate care facility services.
“(7) Inpatient psychiatric hospital services for individuals under age 21.
“(8) Case management services .
“(9) Personal care services.
“(10) Nursing facility.
“(11) Home and community-based services.
“(12) Payment for self-directed personal assistance services provided under section.
“(1) ELIGIBILITY STANDARDS.—
“(A) IN GENERAL.—Beginning on the date no payment may be made with respect to medical assistance provided under a State plan for medical assistance if the State adopts income and resource standards and methodologies for purposes of determining an individual's eligibility for medical assistance under the State plan.
SEC. 205. STATE STANDARDS.
(a) In General.—Nothing in this Act shall prohibit Member States from setting additional standards, with respect to eligibility, benefits, and minimum provider standards, consistent with the purposes of this Act, provided that such standards do not restrict eligibility or reduce access to benefits or services.
(b) Restrictions On Providers.—With respect to any individuals or entities a Member State may not prohibit an individual or entity from participating in the program under this Act, for reasons other than the ability of the individual or entity to provide such services.
SEC. 401. ADMINISTRATION. (1) IN GENERAL.—The Premier Comissioner and the Internal Comissioner shall develop policies, procedures, guidelines, and requirements to carry out this Act, including related to— (A) eligibility for benefits; (B) enrollment; (C) benefits provided; (D) provider participation standards and qualifications, as described in title III; (E) levels of funding;; (b) Uniform Reporting Standards; Annual Report; Studies.— (1) UNIFORM REPORTING STANDARDS.— (A) IN GENERAL.—The Premier Comissioner shall establish uniform Member State reporting requirements and national standards to ensure an adequate national database containing information pertaining to health services practitioners, approved providers, the costs of facilities and practitioners providing such services, the quality of such services, the outcomes of such services, and the equity of health among population groups. Such standards shall include, to the maximum extent feasible without compromising patient privacy, health outcome measures, and to the maximum extent feasible without excessively burdening providers. (B) REPORTS.—The Premier Comissioner shall create the European Healthcare Office that will regularly analyze information reported to it and shall define rules and procedures to allow researchers, scholars, health care providers, and others to access and analyze data for purposes consistent with quality and outcomes research, without compromising patient privacy. (2) ANNUAL REPORT.—Beginning January 1 of the second year beginning after the effective date of this Act, the European Healthcare Office shall annually report to the European Council on the following: (A) The status of implementation of the Act. (B) Enrollment under this Act. (C) Benefits under this Act. (D) Expenditures and financing under this Act. (E) Cost-containment measures and achievements under this Act. (F) Quality assurance. (G) Health care utilization patterns, including any changes attributable to the program. (H) Changes in the per-capita costs of health care. (I) Differences in the health status of the populations of the different Member States, including income and racial characteristics, and other population health inequities. (J) Progress on quality and outcome measures, and long-range plans and goals for achievements in such areas. (K) Necessary changes in the education of health personnel. (L) Plans for improving service to medically underserved populations. (M) Transition problems as a result of implementation of this Act. (N) Opportunities for improvements under this Act. (O) Sanctions to Member States. (1) IN GENERAL.—The European Healthcare Office shall conduct an audit of its Board every fifth year following the effective date of this Act to determine the effectiveness of the program in carrying out the duties. (2) REPORTS.—The European Healthcare Office shall submit a report to the European Council concerning the results of each audit conducted under this subsection. SEC. 402. CONSULTATION. The European Healthcare Office shall consult with State agencies, health organizations, and private entities, such as professional societies, national associations, nationally recognized associations of experts, medical schools and academic health centers, consumer groups, and labor and business organizations in the formulation of guidelines, regulations, policy initiatives, and information gathering to ensure the broadest and most informed input in the administration of this Act. Nothing in this Act shall prevent the European Healthcare Office from adopting guidelines developed by such a private entity if, in the Secretary’s Office judgment, such guidelines are generally accepted as reasonable and prudent and consistent with this Act. SEC. 403. REGIONAL ADMINISTRATION. (a) Coordination With State Offices.—The Secretary of European Healthcare Office shall establish and maintain regional offices to promote adequate access to, and efficient use of, tertiary care facilities, equipment, and services. Wherever possible, the Secretary shall incorporate state offices of the Centers for Medical Care & Services for this purpose. (b) Appointment Of State Directors.—In each such member state office there shall be— (1) one regional director appointed by the Secretary; (2) for each State, a deputy director; and (3) one deputy director to represent minority groups in the region. (c) State Office Duties.—State offices shall be responsible for— (1) providing an annual State health care needs assessment report to the Secretary, after a thorough examination of health needs, in consultation with public health officials, clinicians, patients, and patient advocates; (2) recommending changes in provider reimbursement or payment for delivery of health services in the States within the region; and (3) establishing a quality assurance mechanism in the State in order to minimize both under-utilization and over-utilization and to ensure that all providers meet high quality standards. SEC. 404. BENEFICIARY OMBUDSMAN. (a) In General.—The Secretary shall appoint a Beneficiary Ombudsman who shall have expertise and experience in the fields of health care and education of, and assistance to, individuals entitled to benefits under this Act. (b) Duties.—The Beneficiary Ombudsman shall— (1) receive complaints, grievances, and requests for information submitted by individuals entitled to benefits under this Act with respect to any aspect of the European Universal Healthcare Program; (2) provide assistance with respect to complaints, grievances, and requests referred to in subparagraph (a), including— (A) assistance in collecting relevant information for such individuals, to seek an appeal of a decision or determination made by a regional office or the Secretary; and (B) assistance to such individuals in presenting information under relating to cost-sharing; and (3) submit annual reports to the European Council and the Secretary that describe the activities of the Office and that include such recommendations for improvement in the administration of this Act as the Ombudsman determines appropriate. The Ombudsman shall not serve as an advocate for any increases in payments or new coverage of services, but may identify issues and problems in payment or coverage policies. SEC. 411. APPLICATION OF FEDERAL SANCTIONS TO ALL FRAUD AND ABUSE UNDER UNIVERSAL Healthcare PROGRAM. (1) Exclusion of the European Union. (2) Monetary penalties. (3) Criminal penalties. Shall be enacted and reviewed by the European Court of Justice, and the Ombudsman Office of the European Healthcare Office.
The European Universal Healthcare Act would cover all E.U. citizens with comprehensive health benefits with no cost-sharing. Benefits include inpatient hospital services, nursing facility services, home health services, hospice care, medical care, prescription drugs and biologicals, preventive health services, home and community-based services, and any other medical or health services deemed appropriate.
The program would be administered by the European Healthcare Office (EHO) at the regional level, but states have the option of administering the program at the state level under a state budget determined by EHO. Hospitals and institutions would be paid on prospective global budgets, and physicians would be paid on a fee-for-service basis. The bill ties the increase in the regional healthcare budget to annual growth in the GDP (general inflation). Separate budgets are created for capital expenditures and medical education.
The program would be financed through:
- An increase in the top corporate income tax rate in member states;
- An expansion of the coverage of the revenue of the Regional European taxes that mantain Europolis structures;
- A maintenance-of-effort requirement that states pay into the regional system in order for their citizens to be eligible for benefits.
This is our Act, we call for action, we call for the defense of this Human Right. Any Member State can modify it, but we need a Universal Healthcare coverage for all Europeans!
Lady Emma Granger, 2th Baroness of Montague
His Majesty Councillor for the Kingdom of Montenbourg
I second the motion to bring this bill to the floor of the European Council.
Debate starts from now until 3 March 2018 to 20:00 GMT
The amendment voting period, should any amendments be proposed, will last from then until 5 March at 20:00 GMT
Voting on the final bill will be from that point until 8 March at 20:00 GMT
While I appreciate the Councillor's attempt to extend Eurofederalism to all of us, I and I'm sure many of my other colleagues will not stand for it. Firstly, it greatly grabs power away from organisations of healthcare like Britain's National Health Service and puts its welfare and being in the hands of Europe rather than the people of the United Kingdom, who created this system and have maintained it for almost 70 years.
It creates far more bureaucracy than needed. Why is the European Court of Justice, whose purview is constitutional law and not civil/criminal law, being brought into arbitrate and make sure that we are following the rules? Why the need for an Ombudsman when the Commissioner for Internal Affairs can handle the enforcement of the Act. Why do we need a European Healthcare Office.
Finally, the unfair economic burden of this Union would be even more large in disparity. Montenbourg, forgive me, is a small economy, worth €175 billion. The United Kingdom is a large economy, with a larger population, at €6.4 trillion. Who is paying the lion's share of the contributions already? Why would we want to put an additional tax on business that does not go to the British people but rather to the rest of the European Union? We are net contributors who, while receiving monies back from the Union, largely make more of an investment.
What I would suggest is a treaty that we as nations could sign up to to, on our own, monitor and look after the well-being of our healthcare systems and (should we so choose to) harmonise them with other nations. It would allow national governments the opportunity to express their want to do whatever recognition/swap programme there. I will say that the Lady should check out the European Health Insurance Card, which does provide all Europeans with a card that gives them access to all healthcare in Europe across borders and has a set out payment and repayment structure.
Sir Edward Mountain, 4th Baronet of Oare Manor and Brendon
Councillor for the United Kingdom of Great Britain
Speaker of the European Council
Omnibus last edited by
Sanar Willow stands for her thoughts on the legislation
Regretfully, I have to agree with the United Kingdom. In Omnibus we are all for creating a healthcare system that is for everyone and affordable to all people but we must not force them to accept Universal Healthcare otherwise this will create only a divide in our Union, that we do not need. I urge you to make a treaty that I would cosponsor with you on that would make Universal Healthcare a choice instead of a requirement of the European Union, I hope the country of Montenbourg can have a prosperous friendship in the future.
I have two problems with this Bill.
The first is the principle of demanding that member states institute 'universal healthcare'. First of all, is lack of coverage a problem anywhere in the EU? There's been no survey or investigation to find out; so this legislation could well be trying to 'fix' something that isn't actually broken. Then there's the question of what, exactly, counts as 'universal healthcare' - where do we draw a line between a system that is universal and a system that isn't? And the final issue is, as ever, one of subsidiarity. We are a handful of mostly appointees, equally representing our countries irrespective of population, with no body politic backing us up. It's not for us to make these decisions. Decisions should be taken at as close as possible a level to the people they affect, so it should be for national or even local governments and legislatures to decide how healthcare should be organised. Cross-border affairs? Absolutely, that's our patch. Internal affairs? No.
But this legislation goes further. Instead of just telling us all to organise our healthcare systems in a certain way, it actually lays out a blueprint for a single pan-European healthcare system. What micromanagement! We don't want this system in Angleter. We have our own system, and we don't want to see it torn up and replaced by some other system. Indeed, this legislation will inevitably disadvantage nations that need to change their systems more radically to adjust.
So I agree with Cllrs Willow and Mountain. Let's not micromanage everything, let's not divide the region, and let's not tear up the healthcare systems of the nations of Europe.
Cllr Judith Gibbon
As there are no amendments to the bill, the timetable has been changed.
From 20:00 GMT on 3 March to 20:00 GMT on 6 March, we are in the voting phase.
As such, I, Sir Edward Mountain, on behalf of the United Kingdom of Great Britain, vote AGAINST the proposed legislation.
Montenbourg last edited by Montenbourg
I, Lady Emma Granger, 2th Baroness of Montague on behalf of the Kingdom of Montenbourg, vote in FAVOR the proposed legislation.
Councillor Lady Granger's vote is past the deadline of votes.
With one vote AGAINST and no votes FOR, the proposed Act is defeated.
Sir Edward Mountain, 4th Baronet of Oare Manor and Brendon
Councillor for the United Kingdom of Great Britain
Speaker of the European Council