The Muface crisis looks more and more like one of those soap operas in which, a few seconds after a plot is resolved, it becomes unexpectedly complicated and vice versa. After Adeslas announced on Friday that it is refusing to participate in the second tender to provide private healthcare to civil servants and that some information pointed out this Monday that DKV is considering doing the same, the third company that currently provides services to these public employees, Asisa, does not rule out assuming the weight of the mutual insurance company alone.
“In the first tender we were clear that being the only one (insurer) was not a possibility, but now we are analyzing it,” Asisa sources explain. The Government’s initial offer included an increase in the premium of a cumulative 17% for the years 2025 and 2026, which the three companies currently providing service rejected. On this occasion, the specifications published last week contemplate an increase of 33.5% over three years, until 2027.
In addition to the cake of 4,478 million euros in three years, another of the novelties that the Ministry of Public Service incorporated into the new tender to try to convince the companies was a first incremental based on age groups. “You pay more to insure older groups, and less for younger ones,” they explained then.
This had been, precisely, one of the requests that Asisa conveyed to the mutual society through the preliminary market consultation, a procedure by which Muface asked the insurers to justify their costs, and which it had evaluated “favorably” when it understood that “seems to be more in line with current reality.”
“We are studying and analyzing the documents in detail, looking at the different scenarios,” they insist from Asisa, a health cooperative created 42 years ago and of which more than 8,000 doctors are part. And these scenarios include premium, demographics and age groups, but also the possibility that there are only one or two insurers.
Especially when Adeslas, who resigned on Friday from providing health care to officials under the conditions proposed by the Executive, currently covers more than half a million beneficiaries. As the following graph shows, it is the preferred option for mutualists, followed increasingly closely by public health, where 70% of the new officials already stay.
On Friday, Adeslas made public its decision not to attend this concert, alleging that the model is “economically unsustainable” and that it would generate losses of 250 million euros, almost the same as the company, integrated into the Mutua Madrileña Group and owned by by CaixaBank [que tiene entre sus accionistas al Estado]registered between 2022 and 2024. In its case, the insurer demanded a 47% increase in the premium for the years 2025 and 2026.
Regarding DKV, the newspaper The World assured this Monday that this German company also refuses to participate in this second tender. Company sources indicated to this editorial team that they continue to “analyze the specifications” and are scheduling a definitive response next week.
This insurer, which currently provides health care to almost 200,000 employees and family members, had requested a premium increase of 40.6% for a single year. “We have been warning for many years about the underfinancing of the model,” sources from the insurer said at the beginning of December, citing structural problems that affect the system, such as the age of the mutual group that opts for private healthcare and others such as the expected increase in medical costs.
That request for a one-year concert was not only not attended to by the Ministry headed by Óscar López, but it went from two years in the first offer to three. The package that ends this year was also for a three-year period, from 2022 to 2024.
“The first year we had an increase of 8%, but in February the invasion of Ukraine and the inflationary crisis came and ate it up. From year to year it gives us more security, but it is also greater instability for the Administration,” acknowledge sources in the sector, who fear that the open crisis around mutual insurance will reduce the number of public workers who choose the private sector.
Currently, Muface public workers have the possibility of making one change per year between mutual insurance and public health insurers. This option opens every January, in this case, starting on Wednesday. But the instability of recent weeks represents a sword of Damocles for some voices in the sector.
Even more so if this new tender goes awry and the Government is forced to extend the current contract for longer than already planned. “Who is going to go to an insurance company knowing that they are obligated?” these sources say. Others fear that there will be those who will switch to the public this January and will not return even if the concert, which companies can attend until January 15, comes to fruition in a few weeks.
The PP spokesperson in Congress, Miguel Tellado, accused the Government this Monday of “management failure” with Muface. It is a “very concrete example of management failure with health care that affects 1.5 million officials,” he said, who have their medical coverage “up in the air.” The numbers are increasing, because currently 770,000 public workers and 424,000 beneficiaries opt for private insurance. A total of almost 1.2 million people, according to Public Service data, who would have guaranteed attendance in public.
The PP’s criticism ignores the 33.5% increase in the premium proposed by the Government, despite the fact that the mutual society considers that the insurers “do not provide evidence of costs” to justify an increase. Or that Minister Óscar López has insisted that the assistance of mutualists is guaranteed. The last one, in the Public Function and Finance commission of Congress, on December 18. “The priority is to put out to tender the concert and give security and peace of mind to the mutual members,” he repeated.
Afterwards, the socialist part of the Government is “delighted to debate” the “reforms required” by the model. The Sumar wing, and the Ministry of Health itself, for their part, ask for “a roadmap for the transfer to the national health system when the new agreement expires,” if it materializes.
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