January appears just around the corner and the Muface crisis is not yet over. Although it seems to be starting to get on track: the Government gave in last week to pressure from insurers and unions with a second tender that increases the premium by 33.5% – what is paid for each patient – in three years; Now it is the companies (Asisa, DKV and Adeslas) who have until January 15 to decide whether or not to participate in these new conditions, according to the specifications published this Monday on the Public Procurement Portal. While the Government waits for the companies’ next move, a million public officials with private healthcare continue to “hold their breath.”
These are the words used by Mayka, a retired teacher living in Gran Canary Islands who broke her ankle into three pieces six months ago. After two surgeries and a major infection, he is in the key weeks of his recovery with rehabilitation sessions and periodic check-ups. It is now that the pieces of your bone have begun to come together. “What do I do with my ankle halfway, put myself on the Social Security trauma waiting lists?” he asks himself in conversation with elDiario.es. It is insured at DKV. Her husband has asked to accelerate a pending prostate surgery to January. “It’s not evil at all, but it is uncomfortable. With this example I want to say that we and the doctors are very aware of this situation,” the professor emphasizes.
Jesús Grau, 66 years old, has been undergoing oncological follow-up for almost a decade after suffering from prostate cancer in 2014. In the last check-up they saw some polyps that should be monitored. He also goes to the cardiologist annually because he has hypertrophy in one half of his heart. “When you already have pathologies, things get more difficult,” emphasizes this jurist who retired a year ago and chose Asisa.
Adrián – his name is not real – is also going through the uncertainty with some discomfort. In his case, he receives treatment every month against ankylosing spondylitis – a type of arthritis that causes inflammation in the spine – to relieve the pain associated with the disease. “My fear is that the bureaucracy will make me go two or three months without the injection. I have even asked myself: what if they say no? Each injection costs about 1,000 euros and they are authorized for me, with a report from the rheumatologist, every two years,” explains this state official, also retired and a patient, like Grau, from Asisa, on the other end of the phone.
A point of no return
The three patients are part of that group of officials who have grown up with Muface. The new specifications include a higher insurance premium for them compared to the younger ones (it is no longer linear). They are at the epicenter of the crisis because they are the most numerous – new entrants increasingly choose public assistance – and, at the same time, those that consume the most resources. And they assume that if this model does not fall tomorrow, it will fall the day after. Almost no one thinks that this earth movement will be redirected as if nothing had happened. Although everything goes as expected by the Ministry of Public Service – the one that proposed the new tender –, all parties involved in the conflict assume that the model will have to be reformulated in three years. How long the next concession would last.
Also many patients. Mayka, Jesús and Adrián defend more or less the same thing: a smoother transition of all mutual members to public healthcare that allows for minimal planning. “I have been accustomed to this assistance system for 46 years and in my current circumstances the change causes me serious discomfort, but it is very clear to me that Muface has to disappear. It no longer makes sense for certain officials to have a different regime than the rest of the workers, although the extinction must be done gradually and in an orderly manner,” defends Grau, who never considered a change in these four decades. In January of each year, according to current conditions, mutual members can jump from private to public healthcare and vice versa.
My fear is that the bureaucracy will make me go two or three months without the injection. I have even asked myself: what if they say no?
Adrián, retired civil servant with chronic treatment
Mayka has indeed changed throughout her working life. The first few years he chose public healthcare, he says, until he had a health problem that was not responded to as expected due to the saturation of the emergencies in Gran Canaria. “They kept me lying in the emergency room all day with deathly colic to tell me that my case was not urgent and that they would call me for an ultrasound. It was time to change and I opted for a private insurance company. The matter ended in peritonitis caused by untreated appendicitis,” he recalls. And until today. “I’m not going to lie, I was thinking about going public, but since the ankle hasn’t gone well right now I would have a very uncertain future,” he adds. She remains lame, with a crutch and rehabilitation sessions, waiting for a consultation with the traumatologist in January.
While the Minister of Public Function, Óscar López, admits that Muface is not perfect and “requires reforms”, the Sumar wing of the Government – of which the Minister of Health, Mónica García is a part – is committed to proposing “from now on” a roadmap for the transfer to the national health system once the new agreement expires. The Sumar parliamentary group presented, along the same lines, a non-law proposal in Congress with the idea of marking that path.
Although at the moment the “priority” of the socialist part of the Government, the one competent to manage the crisis, is “to put out to tender the agreement and give security and tranquility to the mutualists.” Save the furniture and undertake to make the necessary revisions within three years. “I want to send a message of peace of mind to all mutual members because they will have their health care guaranteed under the same conditions they currently enjoy,” said the Government spokesperson, Pilar Alegría. In the next three weeks, when the deadline given to insurers to attend ends, it will be confirmed whether the problem has been resolved. At least until further notice.
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