The “significant flow” of people from Alava, Biscay and Gipuzkoa “who settle in second homes” and stay outside the Basque Country for “long periods”, as well as “long-term trips for reasons tourist”, trigger the departure which the Vasco de Salud Service (Osakidetza) allocates an allowance each year to cover its health expenses in the rest of Spain. According to official data sent to the Basque Parliament by Councilor Alberto Martínez, the bill increased from 2.98 million euros in 2013 to 28.62 in 2023. 2024 is not yet closed and it is expected that for 2025 it will reach already the Barrier of 30 million.
The so-called National Health System (SNS) allows Osakidetza card holders to be treated universally in any other autonomous body. On the contrary, patients from other autonomous communities also have access to services in Euskadi. Annually, an assessment is carried out between the two chapters and the relevant compensation is paid. These are the “health cohesion fund” and the “care guarantee fund”. The first includes the cost of care that must be referred to another place due to the absence of a reference center and the second is the one that regulates expenses outside Euskadi itself.
The total of both is clearly “negative” for Osakidetza, meaning she spends much more than she earns. In total, the amount paid is 169.2 million euros over the last ten years and always with an increasing amount. It is also confirmed that visitors to the Basque Country spend much less on healthcare because their stays “are generally of short duration”.
The report was requested from Parliament by the PP health spokesperson, Laura Garrido. Osakidetza explains that “the biggest expense” is largely due to compensation for the purchase of medicines. In 2018, “a substantial increase” was recorded in this position since Euskadi “joined interoperability [de la] electronic network [del] National Health System”, which “made it possible to obtain medicines in other autonomous communities using the individual health card [TIS]”. “This allows citizens of the Basque Country community not to have to travel with medicines for the entire duration of the trip, but to be able to collect them in pharmacies in the destination cities,” explains Martínez.
In detail, this pharmaceutical expenditure item was zero in 2013, it started in 2014 with a cost of around 9 million, it fell to 6-7 million in the following years but it has skyrocketed, in fact, since 2018. In 2023, it came close to 19.5 million euros. The rest of the chapters are more stable and the trends are different. For example, the cost of primary care for Basques outside the Basque Country amounted to 7.6 million last year. This is also the highest figure in ten years and in 2013 it was 5.8 million. However, for “procedures with hospitalization”, the payment was 0.82 million in 2023 compared to 1.93 ten years ago. The government emphasizes that in 2018 an audit was carried out on these funds.
