Three years from now, Estonians should be able to receive non-emergency medical care anywhere in the EU. Officials are optimistic but economic disparity in Estonia and resistance to online technologies remain serious obstacles.

Under the EU directive on freedom of patient movement, any EU citizen can receive care anywhere in the EU, with national health insurance contributing what the treatment would cost in the person’s home country.

Social Minister Hanno Pevkur hails the EU directive as a two-way street.

“On one hand our own patients’ treatment options will improve and become broader, while on the other hand, our doctors currently working in Finland and Sweden could invite their patients to Estonia,” said Pevkur, explaining that they could skip a cross-border house call.

Pevkur said that patients will tend to move toward Estonia, rather than outside Estonia. “One point of the directive is to ensure that domestic patients do not get poorer service than foreign patients,” he said.

But there is some criticism. Patients Advocacy Association spokeswoman Anne Veskimeister noted that the health care service will cost more abroad and patients will have to pay a large margin.

And detractors also point out that Estonian doctors currently go abroad to work because they are not paid enough at home, not because of a shortage of patients.

However, the hope is that the freedom of movement will act as an invisible hand, and that the general quality of health care will improve as it becomes easier to compare different countries.

If freedom of movement is to work, first a pan-European e-health system will have to be established, which allows data on any patient to be accessed in any country. The conventional wisdom is that Estonia is leading the way – it does run the EU’s IT agency, after all – but it is not certain whether it will be ready in three years.

“I am skeptical whether the necessary IT level will be achieved in its entirety by the end of 2013,” said Praxis Centre for Policy Research’s health policy program director Ain Aaviksoo. “A good colleague of mine from Finland who is several decades older than I says that he would be happy if the IT system reaches the state as envisioned by the directive by the end of his lifetime,” Aaviksoo said, adding that he was not “that skeptical.”