The medical coverage of one million people in Spain is hanging by a thread. It’s the other big issue of the week: what’s going to happen with Muface in the coming months? If you are not a civil servant, perhaps you have gotten lost in this health soap opera.
Before delving into the history, I start with the basics to understand everything else: public workers in Spain can choose whether they are cared for by public health or by private insurers (there are three) to which the State pays for their assistance. Might it seem like a contradiction? Well yes, but that’s how the system has been set up since 1975. Almost nothing. The point is that the Ministry of Public Administration renews the contract with the insurance companies periodically and this time none of them have applied for the competition because providing the service is not profitable for them. They have planted the Government.
So on one side we have the companies (Asisa, DKV and Adeslas), which say that what the State gives them as a mutual benefit is not enough; and, on the other, to the Ministry of Public Function, which despite increasing the premium per patient by 17% has been left with one hand in front and one behind. Things don’t seem to end like this: what is expected is that the Government will launch a new tender with a larger budget – here the insurers have the upper hand very well – and that the companies will accept. Although a forced extension of the contract in January to save time.
In it fight between the private sector and the State, the former have everything to win. Their strategy is being 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 surgery, to go to a specialist or to have an appointment in Primary Care.
But let’s go to the numbers to see if that’s really the case. The Ministry of Health is already analyzing the consequences that a possible landing of the mutualists in the hospitals and health centers of the SNS would have. According to the figures managed by Mónica García’s team, the increase in the population served would rise between 2 and 3% at once. And it would grow more, up to 3.7%, among people between 64 and 79 – which is more or less equivalent to the ‘babyboomers’ – because mutual members are increasingly older.
It’s no small thing. I think no one hides that it would be a challenge for the public system, which is not going through its best moment. Especially if it is done abruptly. Professor Beatriz López-Valcárcel, who always does very interesting research work, estimates that 714 more family doctors would be needed immediately. An added pressure, without a doubt. However, she and other experts who know about health planning and management, such as José Ramón Repullo, agree that, if this unlikely scenario occurs, public health would end up “passing the test.”
This crisis has opened up a debate that has been on the table for many years: should we end Muface? It reminds me a little, using a thick line, of what happens to us in Spain with the charter school. It was born to help the public, as a crutch of support, and it has not stopped gaining weight. Let’s see now who thinks that it is no longer necessary. In the case of mutualists, however, the percentage that decides to stay in public health has been increasing. It has risen 66% in a decade and they are now one in three.
While you were doing other things…
- It is suspected that there are two cases of leptospirosis infection in Valencia, a bacteria common in flood areas that is transmitted when the urine of animals such as rats comes into contact with wounds or mucous membranes of human beings. That it passes from person to person is “extremely rare.”
- This week, seeing them coming, we compile the health hazards that are to be expected after a catastrophe like this. Especially because they are preventable.
- “I worked on two tsunamis in the Philippines and this is very similar.” My colleague Pol Pareja has done a house-to-house search with psychologists from the Red Cross in Paiporta. This is what has been found.
At the blacksmith’s house… wooden knife
They ask their patients to get vaccinated but at home they don’t do it. Less than half of the health personnel in Spain were immunized against the flu last year. The figure is the lowest since 2019, before the pandemic, and the curve has been set to decline. In the Balearic Islands, for example, only 15% of professionals were vaccinated in the last campaign. It’s amazing.
The authorities are worried. The last National Congress of Vaccinology, which was held two weeks ago in Malaga, scheduled a specific presentation to talk about the problem without half measures. Very interesting issues came up: among those who believe they are immune, those who claim that they have a lot of work and those who pass… there are also others who have become detached from work due to their poor working conditions.
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#plan #bluff #unknowns #Muface #mess
