Spanish insurers have come to their defense after the Ministry of Health published a report last week in which it claimed that private companies that provide services to civil servants “select risks” to push those that could potentially be more costly to them. public health. The employers’ association that represents these companies, Unespa, denies the majority and assures that such a practice does not exist because it was never their intention, because the Muface agreement (the public body that provides assistance to civil servants) does not allow it, and because it is impossible given that “it is the officials who choose each year the regime they want to join,” the note reads. Related News standard No Mugeju follows in the footsteps of Muface and urgently calls the unions due to the uncertainty of the mutual members Jaime Mejías CSIF has expressed its concern about the uncertainty experienced by the 92,000 Justice officials served by this mutual benefit This dispute began on Monday, when The Ministry led by Mónica García took advantage of the Muface crisis by proposing that the million and a half officials whose private healthcare is in suspense be transferred to public healthcare. It must be remembered that on November 5, the Muface concert was abandoned after Adeslas, Asisa and DKV (the three that participated) rejected the offer because they considered that the amounts were insufficient. From then on, a succession of bickering took place between the Ministry of Public Service, which is the only one that has powers over Muface, and the companies. And in limbo was the Health proposal, which despite the commotion caused – threats from the Csif union included – seems to have been ignored by the department headed by Óscar López, which yesterday launched a preliminary consultation with insurers to explain what price they would provide the service. However, the insurance companies have taken the accusations very seriously. In the Health report, which was released by the Ser chain, it was stated that among mutual members who receive public assistance there is a higher prevalence of chronic diseases such as diabetes, hypertension, heart failure, COPD and systemic cardiology. “There is strong plausibility in favor of the hypothesis that private insurers are engaging in a risk selection phenomenon that pushes mutualists insured with these conditions to switch to public health care providers,” the document reads. With this, of course, the report aims to provide an economic justification for its proposal to extend the agreement for 9 months and gradually incorporate civil servants into public health. Insurers deny the major As has already been advanced, Unespa has denied these accusations through a statement in which it assures that “it is impossible for there to be any selection criteria” given the very nature of the selection mechanism, since it is the officials themselves who choose each year the regime to which they want to join. In fact, the employers’ association recalls, officials have been selecting private insurers for the most part in a proportion that throughout the period exceeds 80%, and they assure that they do so “because of the quality of the service they have received for decades.” In addition, the note, the agreement obliges, for reasons of equity, insurers to assume the costs of treatments in those cases in which a Muface patient has to receive treatment from the public health system, and the costs of said treatment must be met following the prices set by the system public. We must not forget that, precisely, the Muface crisis began due to the losses that the companies claim to have had to assume due to the conditions of the current concert. “The underfinancing of the model already reaches a difference, in relation to the average that the rest of the Public Health receives per person, greater than 40%,” explains Unespa in its statement, before remembering that despite everything it has continued to provide the service and will continue to do so until the concert expires, next January 31.
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