A Byzantine European Patent Office Where Staff Must Beg for Help With Contraception (Worse Than the Rest of Europe)
As noted in this latest meme and recent article (4 weeks ago), today's EPO harms the families of staff - a theme explored by the representation of staff earlier this year as well [1, 2]. Benoît Battistelli and António Campinos seem to believe that they can treat their own staff like dirt and still be able to run a reputable organisation rather than a cheating organisation that breaks laws, causes many suicides, and floods the market with European software patents that only a kangaroo might accept.
The Central Staff Committee (EPO staff representation) has just circulated a report. The communication says the following:
Prescribed contraception to be reimbursed under Cigna health insurance
Dear colleagues,
On the 5th July 2024, staff representation met with the administration to discuss this year’s biennial review of the Guide to Cover, which is the document defining what treatments and medication our health insurance scheme covers.
Regarding contraception, the current regulations state that prescribed contraceptives are “reimbursable only if there is an underlying medical problem”. Staff representation has had a longstanding request to drop the restriction, and submitted a detailed report on the reasons for the request, including that fact that our coverage is disadvantageous compared to many member states, the results of a survey showing staff support, and outlining advice from the WHO, the European Parliament, and the Council of Europe.
We are happy to inform you that during the meeting of July 5th, the administration stated that the arguments could convince, and that the restriction to reimbursement will indeed be removed as of 1st January 2025.
Therefore, contraception that is prescribed (for example the pill, injections, intrauterine devices (IUD), implants) will now be reimbursed at the same rate as all other prescriptions (80%).
Thank you to all of you who replied to the survey and assisted in obtaining this improvement to the reimbursement policy.
This may sound like an improvement, but it's all reactionary, so it's necessary to understand the context of it. Here is the report showing just how far behind the EPO was - in effect spending millions attacking its own staff with lawyers while acting all stingy when it comes to reproductive health, which is relatively inexpensive. Here is the full report complete with the charts:
Report on contraception in the context of the guide to cover at the EPO Compiled by the Staff Representation, February 2024
1. Introduction
The issue of the coverage for contraception in the guide to cover has been raised by the staff representation in the previous two biennial reviews and is again brought forward this year. The cover currently provides 80% reimbursement for prescribed contraception “only if there is an underlying medical problem”. This restriction excludes any provision in the context of reproductive health.
The world health organisation defines reproductive health as the following;
“Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.”Across Europe, discussions surrounding reproductive health have been progressing steadily. Regarding contraception, the advice from various organisations and research institutions is consistent and coherent in their advocacy for improved access, and their assertion that they should be considered an essential part of healthcare. The European Parliament and the Council of Europe have adopted resolutions, with relevant excerpts cited below;
• The European Parliament voted in favour of a resolution in 2021 on the situation of sexual and reproductive rights in the EU, stating that the latter are “an essential element of comprehensive healthcare provision”. It also notes that “access to modern contraception is still hindered by practical, financial, social and cultural barriers”, and refers to the “outdated attitudes towards female sexuality and contraception, as well as a stereotypical perception of women being the only ones responsible for contraception” and “calls on member states to ensure universal access to a range of high-quality and accessible modern contraceptive methods and supplies”.
• The Council of Europe adopted a resolution text in 2020 promoting access to contraception in Europe that called on states to “ensure the affordability of contraceptive methods by including them in national health insurance schemes with adequate reimbursement or subsidisation” and to “consider contraception, including emergency contraception, and maternal health care before, during and after childbirth, as essential health-care services”.
2. Benchmarking
Many countries have adopted policies to expand the coverage for reproductive healthcare into their national healthcare schemes in the context of improving reproductive rights. However, the access to contraception across European countries still varies, as can be seen in the contraception policy atlas. In order to evaluate whether the current reimbursement policy applied to EPO staff is appropriate, the coverage from a number of the member states has been explored, including details that are most pertinent for our guide to cover, and is broadly categorised in the table and map below. The list is not exhaustive, but covers 10 of the member states, with the data sources linked in the table.
Regarding the coverage provided by the EPO, the current guide to cover policy is less favourable than all of the benchmarked countries, in that it provides no coverage for contraception as a means for family planning. The reimbursement of contraception prescribed to treat medical issues such as PCOS or endometriosis, as is specified in our guide to cover, is inherently provided in member states by virtue of its use as a treatment of an illness or disease, and therefore is not addressed in the table above.
The current level of coverage is disadvantageous for staff at the EPO when compared to the member states, creating an outdated image that is now significantly lagging behind the rest of Europe.
3. Staff support
Another relevant factor to consider when reviewing the guide to cover is the opinion of the staff members whom the policies affect, and who’s contributions support the healthcare system. A short survey was launched, which asked staff the following question;
“Do you think health insurance should cover contraceptive methods (reversible/permanent) regardless of the reason?”
The survey was initiated by the women’s network and was available for all staff to complete. The survey was published via staff representation communication channels to obtain feedback from a broad cross-section of staff. A total of 230 staff had responded as of writing, with 76% of respondents answering that they believe that contraceptives should be covered without limitation.
In addition, the women’s network (which welcomes all staff) has held two meetings on the topic of reproductive health in recent weeks, obtaining valuable feedback from colleagues who are invested in the topic, and are planning more in the coming year. The results of the discussions and survey give a clear indication that the staff support a review of the current policy.
4. Request
The guide to cover currently specifies the following;
The level of reimbursement is 80%, as is the case for other prescribed pharmaceutical products in the guide to cover. The remark stipulates a limitation on the reimbursement only when the use of the contraception is used to treat an illness.
In light of the above arguments and considering that the Office would like to provide competitive levels of benefits and be considered a modern organisation that is advancing diversity and inclusion, we propose to delete the remark. Such a revision would reposition the EPO from the back of the pack to mid-level on this issue. Contraception would not be free as in the top performing states, but be reimbursed at 80%. In addition, the reimbursement would be without limitation in age, thus avoiding any additional administrative burden while also following the guidance cited above.
It is considered that this simple proposal results in our coverage recognising reproductive health as an essential part of healthcare, bringing the EPO in line with the advances made across Europe.
The inexperienced examiners probably don't realise just how much the EPO deteriorated over the past decade or longer. Standards were lowered so much that it's unrecognisable and stakeholders publicly complain. █