The Government wants to solve the Muface mess. After the insurers’ sit-in on the Civil Service in the agreement to provide health care to hundreds of thousands of civil servants and their families in 2025 and 2026, the Ministry led by Óscar López has chosen to throw the ball back into the court of private companies . The Executive will open this Wednesday a period of preliminary market consultations, in which companies will have to say how much they would be willing to provide health care to the nearly 770,000 public workers and their 424,000 beneficiaries who have opted for health care today. private.
“We are going to a new tender, but with a new procedure and with a market investigation so that there is transparency,” say Ministry sources. De facto, the decision changes the procedure: if before it was the Government that estimated the costs for insurers, now they must be the ones to calculate these expenses. “We have given numbers, we have offered the biggest increase in history and you say it costs more, well tell me how much it costs,” these voices verbalize.
The preliminary market consultations are included in the public contracts law and they authorize the contracting bodies, in this case Muface, to carry out market studies and direct consultations to economic operators about their plans and the requirements they will require to participate in the procedure. It is not about private insurers setting the price for which they would be willing to participate in the new tender, but rather justifying that figure. “The idea is that they can indicate what premium they offer for each of the age groups and that they provide solid evidence on how these premiums are constructed,” say the sources consulted.
Companies will have 10 days to present that evidence and justify how much money they need to be profitable. Following these allegations, the Ministry will prepare a new specification, without the information offered by the insurers being binding. Companies will not be able to agree on their response either. “We don’t even consider them doing it, because it is illegal,” indicate the sources consulted.
The Ministry of Public Function has insisted in recent weeks that the health care of mutual members is guaranteed under current conditions. The Executive has the ace of an extension up its sleeve that would force Adeslas, Asisa and DKV, the beneficiaries of the current agreement, to continue serving officials with the current conditions for months.
“They have created the situation. The action that the Government has taken has been to approve the largest increase in the history of Muface. That is the objective fact,” say ministerial sources, who assume, however, that a hypothetical new tender will be more expensive. Logic indicates that if any company had wanted to bid for less than a 17% increase, it would have already done so in the first tender.
In recent months, the private healthcare lobby has been promoting the idea that even a 25% increase would be insufficient to provide the service, after years of “losses.” The companies point out the increase in the average age of mutual members, around 57.8 years, the costs due to inflation and benefits above those provided by public health. The failed offer meant a bill of 1,337 million euros for the first year and 1,345 for the second. “We have made an increase of 300 million euros and the budgets are not infinite. When you put in 300 million euros, it is at the expense of something else. We work for Muface policyholders and for 48 million other Spaniards,” indicate sources from the Ministry.
The refusal of the insurers has also created a contradiction in the coalition government. While the Public Service states that the Executive “does not have any of its plans to dismantle Muface”, the Ministry of Health, without powers in this area, has published a report in which it assures that “the current context means that, for the first time “In many years, the possibility of incorporating the mutual population into public health care will be both a viable and reasonable option.”
Although the Public Service insists on dismantling Muface, it is not on the table, they are open to rethinking the model. Something that, in any case, would be done in parallel to the tender and would not affect the next contest, but would be based on the principles of “transparency, efficiency in public spending and equity.” “It is an old invention that has been accumulating layers and has some elements more rational than others. If not, we wouldn’t be where we are. It is evident that there are things to review,” acknowledge these same sources, who affirm that there are “patches.”
One of the options that the Government is analyzing is for officials to choose “once and for all” if they want private insurance or public health. It would represent a change with respect to the current model, which allows mutual members to make the jump from one system to another every January. The measure, the Public Service considers, would make “it easier to plan the system’s sources of income and its sustainability.” But there are more keys that can be touched, such as pharmaceutical spending or some duplicities, such as officials who depend on the autonomous communities, but for whom the central State pays for private insurance.
Even without confirming any of these possibilities, there are two things that seem clear: that the Government is not going to break the Muface deck in this legislature, but that it is open to studying formulas that change the rules of the game.
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