Medical coverage for a million people in Spain is hanging by a thread. This is the other big issue of the week: what will happen with Muface in the months to come? If you are not a civil servant, perhaps you have gotten lost in this health soap opera.
Before getting into the story, I’ll start with the basics to understand everything else: civil servants in Spain can choose whether they are covered by public health or by private insurers (there are three) to which the state pays for their assistance. Does this seem contradictory? Well yes, but that’s how the system has been set up since 1975. Almost nothing. The fact is that the Ministry of Public Administration periodically renews the contract with insurance companies and this time none of them applied for the competition because providing the service is not profitable for them. They crashed the government.
On the one hand, we therefore have the companies (Asisa, DKV and Adeslas), which assert that what the State gives them for mutual benefit is not enough; and, on the other, to the Ministry of Public Service, which, despite the increase in the premium per patient by 17%, found itself with one hand in front and one behind. Things do not seem to end like this: what is expected is that the government will launch a new call for tenders with a larger budget – here the insurers have the upper hand – and that the companies will accept it. Although a forced extension of contract in January to save time.
Inside struggle between the private sector and the State, the former have everything to gain. Their strategy is based on the theory of collapse. In other words: either we do it or the public system does it. The message resonates well in a context of long waiting lists to have an operation, go to a specialist or have an appointment in primary care.
But let’s get to the numbers to see if this is really the case. The Ministry of Health is already analyzing the consequences that a possible arrival of mutualists in SNS hospitals and health centers would have. According to figures managed by Mónica García’s team, the increase in the population served would suddenly increase between 2 and 3%. And it would increase further, up to 3.7%, among people between 64 and 79 years old – which is roughly equivalent to “baby boomers” – because mutual members are increasingly older.
It’s not nothing. I think no one is hiding the fact that this would be a challenge for the public system, which is not experiencing its best moment. Especially if it is done abruptly. Professor Beatriz López-Valcárcel, who always does very interesting research work, estimates that 714 additional family doctors are immediately needed. Extra pressure, no doubt. However, she and other experts who know health planning and management, such as José Ramón Repullo, agree that if this unlikely scenario occurred, public health would ultimately “pass the test.”
This crisis opened a debate that had been on the table for many years: should we put an end to Muface? This reminds me a little, in a thick line, of what is happening to us in Spain with the charter school. He was born to help the public, as a crutch for support, and he kept gaining weight. Now let’s see who thinks this is no longer necessary. In the case of mutualists, however, the percentage of those who decide to stay in public health is increasing. It has increased by 66% in a decade and they are now one in three.
While you were doing something else…
- It is suspected that there is two cases of leptospirosis infection in Valencia, a bacteria common in flood-prone areas that is transmitted when the urine of animals such as rats comes into contact with wounds or mucous membranes of human beings. The fact that it is transmitted from person to person is “extremely rare”.
- This week, seeing them arrive, we compile the health risks to expect after a disaster like this. Especially because they are preventable.
- “I have worked on two tsunamis in the Philippines and this one is very similar.” My colleague Pol Pareja went door to door with psychologists from the Red Cross in Paiporta. This is what was found.
At the blacksmith… wooden knife
They ask their patients to get vaccinated but at home they don’t do it. Less than half of Spain’s healthcare workers were vaccinated against the flu last year. This figure is the lowest since 2019, before the pandemic, and the curve is expected to decline. In the Balearic Islands, for example, only 15% of professionals were vaccinated during the last campaign. It’s incredible.
The authorities are worried. The last National Congress of Vaccinology, which was held two weeks ago in Malaga, planned a specific presentation to address the problem without half-measures. Very interesting questions were raised: among those who believe themselves to be immune, those who claim to have a lot of work and those who succeed… there are also others who have stopped working because of their poor working conditions. work.
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