The number of people taking out health insurance has steadily increased over the last decade. Almost thirteen million citizens in Spain (12,802,665 to be exact) currently have it in our country, according to ICEA, the Spanish Insurance Sector’s Studies Service, responsible for carrying out research and publishing all of the statistics. The number of health insurance policies has grown by 3.34% just in the last year and the average annual growth since 2015 has been 3.51%. And it is this data that has led me to share some of my thoughts in this new blog entry.
First and foremost, the private insurance sector isn’t experiencing the ups and downs of the crisis caused by this pandemic. And I’m referring to the figures. Rather, Covid has upheld a trend that already surprised many in the crisis of 2008 and that has now been affirmed: participating in and taking decisions about health management is a priority. Health insurance is not only thought of as a privilege or a luxury, but rather as a necessity. Regardless of their level of income, citizens value it as something that is becoming increasingly necessary.
Those who criticize private healthcare and try to put it opposite public healthcare show a complete lack of knowledge about the current society once again. They are still thinking about the same statist terms of their grandparents, and they use fixed expressions and the same old clichés, instead of realising that we live in an age in which the citizens have different criteria, priorities and wishes. I’m sure that the 12.802.665 people who have decided to take out health insurance hold public healthcare in very high regard. We are incredibly fortunate to live in a country with strong values, one in which no one is left behind when it comes to receiving any type of treatment in the public healthcare system. However, I also think that, despite that high regard that we all hold, especially in terms of the social nature of the system and the main public health centers of reference, all of these citizens are willing to make a co-payment for peace of mind that, whatever happens, they’re going to be treated. And, what is more, quickly, and with quality care.
And why does this happen?
Firstly, because over the last few decades, health insurance companies have expanded the type of service they offer and have improved their own management and the services and assistance they offer to citizens. In addition, compared to our neighbouring countries, Spain provides quality health insurance which is accessible for broad sections of society. And the data that I gave at the start of my reflections confirms this. Together with accessibility and the high quality of healthcare provided, this has made health insurance a service that citizens want. This is because they also know that it is compatible with the treatment that they receive from public healthcare. It is complementary.
Secondly, I think that citizens are becoming more and more appreciative of having a private alternative, alongside the public system, because they realize that it suffers from organizational, bureaucratic and management problems from its own administration, since there are problems with accessibility, very long waiting lists, a lack of motivation from its professionals and obsolescence regarding the technological equipment in many of its healthcare centers. And, without a doubt, Covid has worsened those problems and will continue to do so in the short and medium term.
I can give you an example with which I am familiar. After Hospital de la Ribera moved to direct public administration, the number of health insurance policies in this area of the Valencian Community increased exponentially. When citizens have experienced a real loss in the quality of the service that they receive, with regard to before the reversion, they look for an alternative in the private sector, in order to guarantee themselves fast, quality and safe care.
However, I also firmly believe that health insurance is important as an accompaniment or an aid to maintain the public system, whilst guaranteeing access to certain services that our system is unable to offer. Private healthcare and health insurance play a key role, one that is good for the system, because it acts as a free co-payment that I think should be encouraged by the Government itself, with some type of tax credit.
I’m a firm defender of freedom of choice both with healthcare and education. As citizens we want to participate and decide how to manage our health or our children’s education. It has been shown that it is much better for everyone to incentivize these freedoms rather than restrict them. Even the current Government has committed to this by bringing incentives to the table regarding a delay in retirement age. Why not do this in healthcare? These are effective measures to encourage a good use of public resources.
I want to finish by pointing out that freedom of choice has also been a reality for many years in the civil service. At Muface, the officials can choose whether they want to be treated in public or private centers (the majority choose private, incidentally). The future is about placing people in the driving seat when it comes to decision making regarding their health.
P.S.Last week, parliament passed a non-legal proposal (NLP) for which the Government was requested to extend direct management to the whole public system, without looking into other ways. This NLP was approved by just one vote. There are people who have asked for my opinion and I don’t want to create a lot of controversy because the subject is clear. Years ago the Constitutional Count left it very clear that the Constitution protects both private or indirect management and direct management. Therefore nobody, not even through an NLP, can limit the current management models, because it’s the same as attacking the Constititution, even though we’re experiencing a time during which some endeavor to attack this text, in order to change the Spanish legal framework. Therefore, as the Constitution says, all management models are valid and these polemics are short-lived. I’m with the 1978 Constitution that has given us the longest period of prosperity and harmony in our history. And you?