This week we have taken out the magnifying glass to look at a reality that worries many people: the waiting lists to go to the dermatologist (the longest in all of Spain), the gynecologist or the traumatologist. The conversation on the stairs, at work or with friends, is more or less the same in many places: “they have given me an appointment for the end of 2025”, “when I go I will have forgotten whatever I have or I will be much worse.” They are things to eat, the daily and transversal concerns of people.
So, he said, we have started to look closely at what the data tells us about the situation. Through them we can get an idea of how patients move and in what directions. We chose the Community of Madrid because has the highest rate of population in this waiting situation (12%). And also because it has built the most unique healthcare system in the coexistence – more friendly for some than for others – between public and private healthcare. Here, and probably in more places, the goose that lays the golden eggs for companies in the sector are, precisely, the public’s patients.
May it seem paradoxical? Not so much if we look at how the system is set up: in Madrid there are five privately managed public hospitals. That is, you can go with your health card from the Madrid Health Service but you will be treated by a doctor or a nurse hired by a company that could be Quirón (in four of them) or Ribera Salud. The Ministry of Health provides an annual budget to these centers that can increase if the hospital treats patients from areas other than its own. The philosophy is that money follows the patient. More patients, more money.
Then there is the Jiménez Díaz Foundation, which is a bit on its own although it is part of the same system. This hospital serves more than 400,000 patients in its area – the center of the capital – and charges money for each procedure that is higher than the public prices set for Sermas hospitals. This was the case, at least, until 2019. when a draft from the Chamber of Accounts revealed these extra costs. In the final version of that audit, however, all those revealing data suddenly disappeared. The chamber justified that it had pruned the report after accepting allegations from interested parties.
This was really a long time ago, five years ago, but since then things have been getting better and better for Quirónsalud, which manages this hospital and three others: Rey Juan Carlos (Móstoles), Infanta Elena (Valdemoro) and General de Villalba. Because? They are increasingly able to absorb more patients from public-public healthcare (we are going to call it that to differentiate it from the privatized one) because this economic incentive per patient allows them to open more appointments and attend faster. A round business? The number of patients who have ended up being referred to these hospitals (either by their own decision or by the offer of the Ministry of Health) It has gone from 28,917 in 2014 to 184,534 in 2023.
Defenders of this liberal model, promoted by Esperanza Aguirre in 2011, believe that it serves the Community of Madrid to reduce waiting lists. Of course They are much more efficient and productive. Detractors believe that it parasitizes the public system, ties it hand and foot, because the rules of the game favor the private sector.
Is something similar happening in your communities? If you are from Madrid, how do you experience it? Tell me, I am all eyes to read your experiences.
While you were doing other things…
- Spain recognized the right to euthanasia to 334 people in 202314% more than the previous year. The law continues to be consolidated in the third year of application although the benefit takes more than two months to arrive.
- The scientific breakthrough of the year for the magazine Science is lenacapavir, an injection to prevent HIV that can take a giant step in controlling the epidemic.
History repeats itself
Around this same time three years ago I wrote an article which was titled: “Technicians encounter government resistance in the sixth wave.” Seems like prehistory, right? This week something happened that reminded me of this story. The Ministry of Health has given up on its intention to carry out, to avoid repeating last year’s chaos, a joint plan of actions to limit the spread of respiratory viruses in winter. A type of common document to adopt the use of the mask depending on the level of infections in each community.
It did not seem like a bad idea when it was proposed a few months ago: eight communities – some from the Popular Party – participated in the preparation of the plan at a technical level and the document went through the filter of the alert presentation. But when it reached the Public Health Commission, where the general directors make decisions, the consensus ended. Later, despite the fact that Health said it would try to redirect it, It has not been possible and the plan will not go ahead. It will be published as recommendations to regional governments, which can develop, in their autonomy of powers, their own strategies and all have a powerful tool against contagion, the best: vaccination.
If you fall into the recommended groups and have not yet been vaccinated, go to the health center. For you and for others. Now that the cold is coming, the contagion curve is already going up.
I’ll wait for you next week with more stories.
Sofia
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