Nine years after collecting 740,000 signatures from citizens in the streets, the initiative aimed at reducing the co-payment for dependency returns for the third time to the Congress of Deputies this Tuesday. This is a law, handled under the name ILP (Popular Legislative Initiative), which has already successfully passed the first parliamentary process in 2017 and 2020. In both cases it was taken into consideration, c that is to say that the deputies agreed to deal with it, with the almost unanimous support of the deputies. the hemicycle, but the process stopped during the modification period despite the fact that only the PNV voted against during the first filter. And so until today.
The proposal is promoted by the Spanish Committee of Representatives of People with Disabilities (Cermi) and aims to modify two articles of the Dependency Law of 2006 to exempt people whose income does not exceed 2 from paying part of the cost of benefits, 5 times. the IPREM (1,500 euros per month) and guarantee that in cases where the co-payment is maintained, the person will be able to keep a “minimum amount” for their personal expenses, which will be 40% of the IPREM (240 euros) .
“In no case”, affirms the ILP, “the beneficiary’s participation in the cost of services will exceed 60 percent compared to the reference price which has been set for them”, adds the text which is debated again this Tuesday at the Lower House. Home. When setting the price, “age, the time of onset of the dependency situation and its more or less long duration throughout life” will also be taken into account.
Almost everyone has always supported its consideration, but then that support falters and the treatment is eternally relegated. Whoever has power in the Congressional Council imposes an indefinite extension of amendment deadlines
Luis Cayo
— President of Cermi
“The fact is that almost everyone has always supported its inclusion, but then that support falters and the treatment is eternally relegated when it begins its journey as a bill. This happened with governments of the PP, PSOE, alone or in coalition. Whoever has the power in the Congressional Council imposes an indefinite extension of the amendment deadlines, the legislature exhausts itself, and since it does not decline because it is an ILP, it appears in the next one,” explains Luis Cayo, president. de Cermi, in conversation with elDiario.es. He calls this “the eternal return.”
On this occasion, the legal text benefits from a favorable report from the Ministry of Social Rights, with dependent powers, confirms a spokesperson to elDiario.es. “We believe that the need to develop the dependency system cannot be postponed and, therefore, the financing of the dependency system must be increased and obstacles such as co-payment must also be eliminated,” emphasize ministerial sources, who emphasize that “co-payment contributes to “the exclusion of the most deprived people from the system and, therefore, their elimination establishes minimum bases of equity”.
Cermi considers that, despite the report, for the government this is a “hostile issue” which “can generate tensions with the autonomous communities”. “What users would save would have to be paid for by someone and we have the feeling that they prefer to leave it forever,” Cayo explains. The Ministry of Social Rights is awaiting a reform of the dependency law in which some of these changes could be introduced.
What users would save has to be paid for by someone and we have the feeling that they would rather leave it forever
Luis Cayo
— President of Cermi
The ministry’s own documents include the recommendation to “redefine the current quota model to increase horizontal and vertical equity.” This sentence is included in the latest evaluation report of the Autonomy and Dependency Support System (SAAD), which specifies that “the notion of economic capacity, a basic element for determining the amount of the beneficiary’s co-payment , must be the same in all autonomous communities. There is no uniform application of user fees. Each community, having powers, establishes its own.
The opacity of the user ticket
The dependency co-payment has always existed. These benefits have never been subject to free public health and education. Recipients of a benefit must pay a contribution proportional to their income. Initially, the funding was distributed as follows: 33% for the State, an additional 33% for the communities and the remaining 33% for the user. However, the economic crisis and budget cuts imposed by the central government have unbalanced contributions. That of the State continued to decline, while users assumed a greater share.
What users contribute is an opaque question, Cayo explains. “The system is not transparent and no one knows what weight the co-payment has in the dependency system. The State does not collect this information, so we could not calculate how much it would imply, in terms of public funding, to exempt certain people,” explains the president of Cermi. And he adds: “But we are not maximalists, the law does not necessarily have to come out as it arrived, there can be negotiations.”
Various studies have attempted to address user fees. A study carried out by the Caser Foundation calculated user fees for different services after the 2012 funding reform. For the lowest brackets, the cost borne by the user of a residence, for example, was 259 euros per months, compared to 1,440 for the highest pensions. The average was 960 euros taken out of the pockets of the beneficiaries.
Another study published in Gaceta Sanitaria in 2017 placed the average co-payment at 50%, although in the case of residential it reaches 70%. “The need to reduce public spending and increase collection has led to a considerable increase in user fees. Even if it is true that at the beginning the recovery by user fees was low, our study shows that the 2012 reform increases the user contribution above the 33% established in 2006. On the other hand, the differences between autonomous communities imply unequal application. “, underlined the researchers.
The shock plan promoted by the former vice president of the government, Pablo Iglesias, increased the share of state financing and the current Ministry of Social Rights (Sumar) is committed to ensuring that the state reaches 50% of the contribution. Let it be equal to that of the autonomous communities, even if the first increases had an undesirable effect. Some communities took advantage of the increase in state funding to reduce theirs. Social rights penalized them in 2023.
When the ILP was promoted, backed by hundreds of thousands of signatures, opinions were divided. The Coordinator of the Platforms of the Dependent Country of Valencià rejected it, arguing that accepting by law that people with a certain income co-pay for services “opened the door to the destruction of a system which should be universal and guaranteeing of a subjective right. .” The law, however, protects the benefits of people who cannot contribute due to their zero economic capacity.
“The ideal would be for there to be no user fees, whether like health and education, where the majority of benefits are not conditional on economic capacity, but as this system has always been under -developed, we will start somewhere and, when it is consolidated, we aspire to have no co-payment At least so that there are no grievances,” justifies Caius.
From Cermi, we hope that this time the same thing will not happen again, that a law, born from the only means of direct democracy we have, is not “left in limbo”.
