This Tuesday, Muface made public the final report of the preliminary market consultation for which they had asked insurers to present their allegations and justify how much budget and under what conditions they would be willing to provide healthcare to civil servants and their families who choose for private healthcare through mutuality. Two of the current providers, Asisa and DKV, have attended this call, although this procedure is not binding for any of the parties and other companies may participate in the tender, which the Government plans to publish before the end of the year.
In the report, the mutual society points out that “it would have been desirable to obtain more information on the costs that justify the increase in the premium by the operators.” The companies have already rejected an agreement that represented a cumulative increase of 17% for 2025 and 2026, which had led the Ministry of Public Function to activate this procedure, so that the companies can justify their costs. However, the entity concludes that “the operators’ response does not provide the evidence of costs that make up the total premium.”
One of the operators “limits itself to indicating that, for all cases, direct costs represent 93% of the total.” The other, “under the breakdown of estimated costs by insured, makes a distribution of the premium amount through a mere imputation between direct and indirect costs, without indicating what they correspond to, except in the case of medical scales, which are considered costs. direct and an increase of 8.25% is attributed to them.” “Analyzing the information, it is deduced that the majority of the expense is direct cost, which includes the assistance provision itself,” the document indicates.
A premium for age groups
What the entity evaluates “favorably” is the proposal to “increase premiums by age groups, understanding that it seems to be more in line with the current reality of mutualism.” Precisely, insurers had been indicating that the increase in the average age of their beneficiaries increased the costs of the benefit. Thus, one of the operators “proposes replacing the current linear premium for age brackets with an incremental premium for age brackets.”
According to the reasoned report, which will form part of the contracting file although it is not binding for the agreement prepared by the Ministry, the two insurers that have presented their proposals differ in the increase in the premium by age group, since while one “experiences an increase that varies according to the groups”, the other “uses the traditional linear increase”.
Although the report does not include figures, as this media had learned from DKV sources, this company had requested an increase in the premium of 40.60%. From Asisa they stated that, although the budget is “a central element, it is not the only one.” The other company that currently provides service is Adeslas, which does not appear in the document published this Tuesday by Muface. The company had sent “a letter with several attachments,” which seems to indicate that this communication was made outside the procedure.
A new tender “before the end of the year”
The Minister of Public Function, Óscar López, insisted this Tuesday on the message of “tranquility” to mutual members. From the press conference after the Council of Ministers, in which the issue was not addressed this Tuesday, the now also new secretary of the Madrid socialists has announced that the new tender will be ready “before the end of the year.”
Muface has published the report after preliminary consultations a day before the unions step on the accelerator of the protests. Several organizations, led by CCOO and UGT, will gather this Wednesday morning in front of the headquarters of Unespa, the insurers’ association, and in the afternoon in front of the provincial headquarters of the mutual society to demand that the survival of the system be guaranteed. . The Independent Trade Union Center and Civil Servants (CSIF) will present a document in Congress in which it collects “a multitude of complaints” from beneficiaries for whom insurers have delayed, suspended and canceled appointments. This same Monday, they did the same before the Ombudsman, while the companies deny that it is happening.
The Spanish Federation of Associations of the Higher Bodies of the State Civil Administration (Fedeca), which brings together the highest-ranking officials, published an analysis this Monday in which they affirm that “the renewal of the agreement is desirable from the point of healthcare and also economic view” and that “there is no evidence that questions its sustainability.” In the report, they cite that the end of Muface would mean a 266% increase in waiting lists for outpatient consultations and a 115% increase for surgical interventions, according to data from the Chair of Sustainable and Responsible Health of the Complutense University of Madrid, promoted by the Spanish Private Health Alliance (ASPE), one of the lobbies of the sector.
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