Today, from this important forum, I believe that the time has come to raise a loud and clear voice of alarm at what could be not only an attack on the pillars of our National Health System (SNS), but also a very serious risk of the safety and quality of care provided to all its users.
It is true that to say today that the SNS does not require urgent reforms and regulatory improvements and, above all, the design of better financing, would be to deceive everyone, but allow me to affirm today that, nevertheless, and unfortunately, it is better not to do nothing, but introduce changes and ideologized, unrealistic and deceitful models that mean definitively blowing up our SNS.
Minister García, historical leader in mobilizations against the demagogically called “privatization of public health” and also a participant, as minister, in the one held last May (breaking the objectivity and neutrality that a Minister of Health in Spain should have with 17 systems regional health services, each with its peculiarities and its management and financial problems), promotes what we hope will be “unborn” future Law of Public Management and Integrity of the National Health System.
This draft Law is configured forgetting that the SNS has been built and strengthened from its global conception, that is, considering public and private healthcare as a whole, capable of uniting synergies and providing the best and most efficient quality of care, despite the very serious insufficiencies and economic and human resource limitations that it has.
From this false reality, the objective of the future norm is very clear, as stated in its own report, “to avoid the management of public health services by private health care and to facilitate the reversal of these models” due to a state legal imperative, and not by decision, where appropriate, of the competent administrations responsible for health, which are none other than the CCAA.
All this, without forgetting the elimination of the concert regime, which, by the way, helps a lot to shorten the unbearable waiting times (waiting lists) due to the inability of the public system to assume them due to lack of professions (responsibility of the Ministry ) and means (due to insufficient financing of the system, among other reasons).
In this framework, making the tortuous contrast between the “Catalan model” and the “Madrid model” is simply to ignore both models in depth or to try, through deception, to manipulate public opinion, given that we are, in the Catalan case , in the face of a historic mixed model based on consultation and integration into a single network of public use of all health resources, regardless of their ownership. As if these threats were few, in recent months we have witnessed what could be the “final tip” of the current SNS.
I am referring to the storm unleashed with the renewal of the State agreement with MUFACE, its insufficient financing over the years and the putting at risk of the health care of 1.49 million public employees by taking the insurers who They provide this service at unbearable losses, despite the very precarious remuneration (almost unworthy in some cases) that they pay to the health professionals on their medical staff for caring for these patients.
Another almost 600,000 people from ISFAS and about 95,000 from MUGEJU would be added to this “storm”, that is, more than two million citizens/patients. It is said that the “problem” is strictly economic, considering increases (17.12%) that do not in any way cover the losses of insurers and that are distanced from the real cost of the healthcare provided.
However, the truth is that, once again, the ideologization of the health care model of this Government and, above all, on the part of this Government, could lead to the “temptation” to eliminate this system directly or by inducing the material impossibility of assume it, or forcing the insurers to assume it (they need it due to volume), but leading them in the short-medium term to a delicate economic and “solvency” situation, which could “justify” an intervention by the themselves by the State.
This would deal a death blow to the private sector, motivating the integration into the collapsed and underfinanced public system of these two million patients who would have to be cared for by the CCAA within the framework of their powers.
With this situation, regardless of the not easy decision made by the insurers (ADESLAS, DKV and ASISA, given that the others have already abandoned the model), it must be said that the system is already a pressure cooker ready to explode.
Insurers cannot afford million-dollar losses in this concert, which increasingly has a broader portfolio of services to attend to and a medical team that will no longer resist a remuneration system that is alien to reality and almost insulting.
Although all this may be very good for the policy and objectives of the current Minister of Health, if someone does not see beyond the short-term health demagoguery in which we are installed and does not adopt an intelligent strategy that implies a global solution for the future of our SNS (public and private), I predict a progressive and intense deterioration of what has been our successful health model for decades, which we have exported and which many have envied and envy.
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