Being in need of medical care principally implies being in an extremely vulnerable position which often involves ‘extraordinary moments of fear, anxiety and doubt’. Accessing healthcare in a state other than the state of residence might significantly increase the number of potential sources of difficulties, which are consequently very likely to add to the feeling of being helpless and exposed in such situations. Rights provided by law are of no use to the addressees of these rights if the rights themselves cannot be effectively used and enforced by the power of law. This is no different for (cross-border) healthcare rights either.

Each patient comes across different boundaries when accessing healthcare, both of a legal and non-legal nature. Busse and his colleagues identified six hurdles of access, namely the population covered by health insurance, the benefits covered, cost-sharing arrangements, geographical barriers, organisational barriers and the utilisation of accessible services, whereas the European Commission mentioned the following barriers: lack of insurance, high costs of care, lack of information about services provided, language and cultural barriers. The obstacles related to information and communication are usually among the first ones cross-border patients faces: linguistic barriers and the lack of reliable information were explicitly referred to by the Court of Justice of the EU as potentially discouraging factors of cross-border patient movements.

Patients’ right to information is a fundamental human right embedded both in international standards and national legislations. In a cross-border setting, this right is possibly even more complicated to enforce, thus problems related to communication and access to information are addressed below.

LINGUISTIC BARRIERS

Communication is a key element of healthcare provision, in the course of which it is of essential importance that each party involved expresses him/herself clearly and exactly. If the mutual communication works properly, it ‘ultimately leads to an enhanced doctor-patient relationship resulting in satisfaction with the encounter by both parties and thus improved health care outcomes’, whereas the lack of or inappropriate information exchange might result in incomplete medical assessment, distrust between the parties and inadequate medical treatment. Interestingly enough, this problem has not been addressed on EU level so far.