The Ministry of Health is evaluating the “impact” that taking over the public system would have for the million Muface mutual members whose health care is hanging by a thread after the civil servants’ medical coverage competition was void. Mónica García’s team has begun to carry out this work “in an exploratory manner” to, in the event that the transfer occurs, to measure what effect it would have on public resources according to the territories and the different age groups, ministerial sources have advanced. , who assure that they do not want to “interfere” in a negotiation process in which Health does not participate.
According to the calculations made so far by Health, the transition of Muface officials to public health would mean increasing by 3.7% the volume of population covered by the National Health System (SNS) in the range of 64 at 79 years old – the so-called baby boomers– and 2.35% in people over 80. The percentage of people who are more cared for, if this situation finally occurs, is between 2 and 3% compared to those who already have their public health card. There would be more people, remember Health, but also more resources, because the budget that is now allocated to Muface would be directed to the SNS: 3,571 million euros according to the last concert.
Minister Mónica García has stated unequivocally in recent weeks that the Muface system “is not a priority” for her team and has called it “anachronistic.” “It gives conditions that are different from the rest of the citizens and, in my opinion, they are not better,” he said in an interview on Cadena Ser. With the refusal of the insurers to present an offer for the contest, the Ministry reiterates that “ “It is not understandable that in a country that has public healthcare as one of its prides, its public employees are served by private healthcare.” However, ministerial sources add, “the negotiation processes must be respected and we are not going to disturb or interfere in said process.”
Adeslas, Asisa and DKV, the three insurers that provide the service, slammed the door this Tuesday on the conditions posed by the Ministry of Public Function: a total amount of more than 1,337 million euros for the first year and 1,345 for the second, with a total biannual increase of 304 million euros compared to the last year of validity of the previous concert, 17% more. The average premium per mutual member was around 1,032.12 euros this year and 1,208.81 in 2026. After this resignation, Muface first announced that it was preparing a new tender, although this unprecedented scenario has made the Executive consider extending the contract with the insurers while unions threaten mobilizations due to the “lack of a clear plan.”
An eventual landing of officials in the public system is an increase in caliber that “would represent an enormous challenge” although “this way of presenting it,” warns José Ramón Repullo, “is an argument by insurance companies to force negotiation.” The expert in health planning and health economics thinks that the “threat” will not be fulfilled, but that it may have the effect of “increasing the amounts” offered by the Government for the concerts. “The SNS is not in a good situation, but I have no doubt that it would end up passing the test,” he adds.
A month ago, the Ministry of Health appealed to the fact that “people covered by insurers tend to have less use of health services due to a better average state of health” and anticipated that “there would not necessarily be an intensive and immediate use of health services.” health” in a scenario where all officials would go to the public to counteract the “collapse” argument used by the lobby of private healthcare.
Three reinstatement precedents
There are precedents for the return of high volumes of patients to public healthcare. “In 1983 there were 400,000 self-employed workers who joined INSALUD from one day to the next; In 1989, 250,000 poor people (on welfare) followed the same path; and currently nearly 700,000 non-regularized immigrants are inevitable “clients” of the National Health System (SNS),” recalls Repullo, who also raises the following reflection. “Would anyone have expected the SNS to overcome the deluge of demand and morbidity caused by COVID?”
“In relative terms it would not be catastrophic,” resolves the professor and researcher in Health Economics Beatriz López-Valcárcel, but there would be a “transition” problem in the short term. “Suddenly incorporating this group of one million people would put enormous added pressure on the public health care system, which would have to adapt its offer and organization and that would require a plan. Taking into account the average number of health cards per family doctor (1,400), about 714 more family doctors would be needed immediately,” develops López-Valcárcel, author of the report. ‘The Muface mystery, selection for risk or worsening of perceived quality?’. The study already pointed out in 2019 that the aging factor and risk selection were key to understanding the phenomenon.
The IDIS Foundation, which brings together the private sector, stated in September that a 25% increase – even greater than what has occurred – was also insufficient to achieve “fair” conditions. Its president, Juan Abarca, has appealed to the growth in the age of mutual members as one of the causes of the “inefficiency” of the model for private healthcare: “in Muface there are 31% of insured and beneficiaries who are over 65 years old, compared to 21% in Isfas (State Security Forces and Bodies) and 16% in Mugeju (Justice officials). ”No one is unaware that the older you are, the more accidents. We already know that 80% of healthcare costs are consumed by 20% of the population; the elderly and the chronically ill,” Abarca justified this week.
There are different positions depending on who you ask. One that a portion of experts, such as Repullo, share is what they call “Muface to be extinguished” and involves moving towards a progressive elimination of this concert system. “The new groups go to the SNS, and the changes to the SNS are not reversible. With this option no one is harmed, and by providing sufficient information, the expectations of the insured would not be frustrated,” he argues in conversation with elDiario.es.
This would allow, according to his criteria, a transfer with “a reasonably long period of time” that would avoid “many problems.” “If accompanied by good financing of the residual mutualists, the requirement for Primary Care, and the incorporation into the information systems (and the prescription) of the SNS would help to manage the dysfunctions of the model and its interferences with the majority scheme,” ditch. López Valcárcel agrees: if an absorption occurs, it should be gradual and ordered “with criteria of medical necessity and feasibility.”
#Muface #impact #public #health #babyboomers #enter #system
