Public private partnership models have a long tradition in the Spanish healthcare system. It is the case of the Spanish model for dispensing chemists, an example of private management of public services, which is highly valued by the citizens. However, in terms of healthcare management, we must distinguish three fundamental models: Muface, the concession system and the concessions between government and the private sector.
Today I would like to reflect on the Muface model, given that at the moment it is a subject of great debate. This model has been operating in Spain for over 30 years, but I must add that it is not a complementary model to the public system but is a REPLACEMENT model which, paradoxically, is favoured by 2,000,000 civil servants every year. In January, they will all decide if they want to receive health care through the public health system or from private health insurance companies. It is remarkable that approximately 85% of teachers, judges, military personnel and civil servants throughout Spain, opt to receive their healthcare and that of their families through private companies and not through the National Health System. A surprising piece of data, is it not?
At the moment there is a media debate in which major political parties like PSOE (Battery of parliamentary questions tabled by PSOE about Muface), IU-ICV (Battery of questions on Muface submitted by the IU-ICV member of congress Joan Coscubiela) and UPyD (Parliamentary question by UPyD on Muface), Along with trade unions and social entities such as CSIF and CCOO who are campaigning to maintain and defend this REPLACEMENT model. And that is fine from my point of view because if the Muface model works well, is satisfactory for the users and represents a saving to the Administration, then it should be maintained. In fact, some trade unions are asking Central Government to increase payments to the private health companies to maintain this model. I find it interesting to see how social organizations are concerned about the solvency of these private companies.
But what is most striking about this whole situation, which I cannot overlook, is that these voices calling for continuity in the Muface model are the same ones who criticize the ‘Alzira model’, a COLLABORATIVE and COMPLEMENTARY model integrated within the National Health Service which contributes to its sustainability and innovation while maintaining values of equity, solidarity and universality for all citizens alike.
I am convinced that the responsibility of all actors and that of adding to rather than dividing are values that today, more than ever, we should demand of public authorities, social partners and the business sector in general. Therefore, we should all contribute to keep private public collaboration models. Given its long tradition and success in providing satisfaction, good healthcare and economic benefits to the public purse, I defend the Muface model.