This week the Council of Ministers presented a bill that seeks to facilitate immediate and free universal access to public health for all citizens, which includes all immigrants residing in Spain, regardless of their administrative status. In this way, it intends to avoid the dysfunctions noticed in some communities.
Until now, the rule gave rise to an interpretation that allowed some hospitals to deny them health care. The PP government cut that right in 2012, and the PSOE reversed that policy in 2018, but left an ambiguity in the text that made it easier to reject immigrants if they could not prove that they had been in Spain for more than three months. new project also guarantees free health care for Spaniards residing abroad on their visits to the country.
The draft law on equity, universality and cohesion of the National Health System proposes other specific advances to prevent the different health services of the autonomous communities from establishing barriers that hinder access to certain services for vulnerable people.
The aim is to ensure a common portfolio of benefits for all citizens. The project eliminates the copayment on prosthetics for pensioners with lower incomes, minors with disabilities and people at risk of poverty or recipients of the minimum vital income, groups for which the Government had already eliminated the copayment on medicines.
The bill establishes the primacy of the public health network as a general criterion and limits the possibilities of privatization in the provision of services. To this end, it establishes a series of requirements to out decision care and the need to motivate the to contract it to private providers.
The objective is to limit this possibility to cases in which it truly represents a benefit for the system, and thus avoid policies of systematic “substitution” of the public service for private attention with patronage criteria or parasitism of public resources.
The reaction of some of the agents involved seems, to say the least, exaggerated. The sector’s employers, the Spanish Private Health Alliance (ASPE), accuses the Government of turning Spain “into the only European country that bans private health from its National Health System.” It does not seem very close to reality when, in theory, it is about establishing criteria with the force of law that prevent the excesses already detected in various communities in privatization of services.
The Interterritorial Health Council, in which the communities are represented, will now have to establish the guidelines and indicators to determine whether or not an autonomy meets the criteria set out in the law and to what extent it is advisable for a public service to be provided by a private company.
If this filter really works, it must become the guarantee that the sphere of the autonomous communities is respected and sphere of competence where conflicts and their solutions are discussed. The political objective of putting an end to the routine and unnecessary privatization of health care must now find a concrete formalization in the parliamentary route that awaits him. At the moment, the project presented by the Ministry of Health does not have guaranteed the support of the minority partner of the coalition,