For responsible health

In today’s blog I want to share an interview that I had recently with  La Voz de Galicia.

The Ribera Group and Centene’s commitment to the Galician Community has been evident for several years. We manage three hospitals there: Ribera Povisa, in Vigo; Ribera Polusa, in Lugo; and since just a few weeks ago, Ribera Juan Cardona in Ferrol. And it is for that reason that in the interview I express, once again, the methods to make the healthcare system sustainable and I firmly reiterate that it would have been impossible to respond effectively to the pandemic without the collaboration of the private sector. We are committed to a responsible health model, and that is the key to facing the challenges of the system and guaranteeing its sustainability. 

You can read the interview below.

The third biggest North American insurance company, the giant Centene Corporation, has three hospitals in Galicia, through , their Spanish affiliate, Ribera Salud. The executive director for Europe, Alberto de Rosa (born in Valencia in 1962, “the 17th, October, like Pablo Iglesias and  Isabel Díaz Ayuso”, he insists), reflects on the challenges of the healthcare system after Covid.

– The pandemic has brought to light the need for strong heathcare systems. What role can private healthcare play?

It would have been impossible to repond to the pandemic effectively without the collaboration between private healthcare and public administration. The sector has collaborated loyally. It is a lesson from this pandemic: we should seek lines of communication. We must rethink the healthcare system and the role that we want private healthcare to play.

If public healthcare would not have coped with everything, as is said, it could be interpreted that what is needed is to strengthen it.

Everything has to be strengthened. We have a great public system, with values that we all want to keep: universal, free and with equality. But the society in which we live has to be taken into account. 22% of citizens decide to take out private health insurance, in addition to the public system. Why? Because people want the peace of mind of the public system but they want to have flexibility, the ability to choose, the immediacy and closeness of the private sector. We want a strong public system and in order to get that we need an outstanding private system.

-It is strange, because in the 2008 financial crisis the number of people taking out private health insurance also increased. If the system were strengthened and waiting lists were eliminated, would there be less people insured?

– I am one of those who likes to speak less and less about public and private. It is motto that I want to introduce in the group: a responsible health model.

– What does it mean?

We have to look at the challenges that the system faces. The fundamental aspect is sustainability, both in the public sector, financed through taxes, and private, financed because people pay for it. Some insist on making distinctions, when people have a clearer picture. To sustain the system everyone involved has to contribute.

-You speak about re-thinking the system. Share your thoughts. 

We have to advance to a more digital health system. We were the first group to implement electronic records and we’re implementing a health portal. We have a healthcare system that was designed in the 80s, and society is different. The hospital has to break down its walls and have  more to do with primary healthcare, social services and the patient’s home. 

– How can the system be made sustainable?

There are challenges such as the evolution of costs, ageing, new diseases, technology etc. I would propose going back to doing what was done at the start of the 90s, the April report, in which the healthcare experts pool their ideas.

– Do you like the methods that the April report proposed? It spoke about co-payment, public-private collaboration etc.

I have never advocated for co-payment, it can be unfair. There are other ideas that I agree with. A lot of things need to be re-thought.

-In the 90s, Ribera Salud started the Alzira model: the Valencian Community was responsible for the management of the whole area of health, hospital and primary. Is that the model?

There are a lot of grey areas in healthcare. The model was very interesting for some specific situations. It worked very well, allowing multi-million investments. There are other forms of collaboration that have worked incredibly well, such as Muface, in which civil servants choose between receiving healthcare in the public system or in private companies, or pharmacy offices, for example.

– The PSOE and Compromís government let Alzira’s concession expire and they have already announced the same for Torrevieja.

Three years later, Alzira’s return back to public management was a disaster. Public data shows that it costs the Valencian Community 80 million a year more than before. Waiting lists have tripled. Citizens had quality healthcare. In the middle of a pandemic, it would be worth not trying to fix something that isn’t broken.

  • «We want to work very closely with Sergas» 

In October, Alberto de Rosa left his position as CEO of Ribera Salud to become the Executive Director of Centene in Europe. He says that he only asked to keep one position: that of the president of  Povisa’s Nursing School trust.

– They have bought three Galician hospitals in less than two years. Why this sudden interest in Galicia?

We had a very close relationship with Povisa for a long time and expanding into Galicia acquiring Povisa was an extraordinary opportunity, one of which we feel very proud. When we expand into a community, we study if there may be other opportunities. Polusa (Lugo) and Juan Cardona (Ferrol) appeared and we’re happy. But the initial idea was to incorporate Povisa into the group. When we started in Galicia we were only present in two communities (Valencia and Madrid), now in four (with Galicia and Extremadura) and I can now announce that we will soon be present in five.

– Which? 

I’m not saying any more. In the countries where we are present we are going to commit to continuing to grow. 

– In Galicia too?

We’re open to any opportunities that come up, but I’m not going to say anything else.

– You took over Povisa in December and the pandemic came in March.

It was very fortunate for the group, which received a great deal of help from Povisa, and I also like to think for Povisa. Groups can help in situations like this.

– What kind of relationship would you like to maintain with Sergas? Your three hospitals have agreements.

I would like to work very closely with them, helping them and providing them with ideas and initiatives that could be positive. The concept of loyalty is important for us.

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