Proposed changes to Spanish healthcare system

[timr]

I hope the following might be of interest to any pre-retirement age British residents here who currently have health care either through a "dummy" autonomo, private medical insurance or The Valencia cuota scheme.

Briefly, a bill has been introduced into Congress (14/05/2010) which would require the Spanish Government to introduce a free and universal healthcare system for all residents (including foreigners) from the start of next year. The bill explicitly removes the need to pay into the Social Security system as a condition of accessing the health services here. Although there is a long and complex story behind this, the key points were unanimously agreed by all main political parties (PP, PSOE, IU etc) back in September of last year, and the proposal received the support of the Government in April (although without a commitment to a firm timetable). The current bill restates what has already been agreed but with a timetable. If the bill is approved , Spain will have a system virtually identical to the NHS from 01/01/2011.

Here are some links to reports in the Spanish media which pretty much summarize the story to date;

The vote in Congress Sept 2009 asking the Govt to take whatever measures necessary to guarantee a universal and free healthcare system in Spain.

El Congreso exige al Gobierno que garantice la asistencia sanitaria gratuita a todos los españoles. europapress.es

A report on the Government response in April in which they agree but without specifying a timetable:

EL GOBIERNO VUELVE A ANUNCIAR LA LEGALIZACI

Finally a report on the binding motion in front of Congress on 10/05/2010 which would require the Govt to put the system in place on 01/01/2011.

IZQUIERDA UNIDA RECLAMA LA UNIVERSALIZACI

[Rob1305]

Very interesting post.
I assume this ties into the piece in this weeks Coastrider pg 3 - which I found a bit confusing. But the bottom line looks good for everyone. Where is the catch?

[timr]

Hi, the Coaster rider article is about cross-border health or "health tourism" - the rights of patients to seek treatment in another EU state and which Government actually pays for it. I find this pretty confusing as well. The info I posted is about changes which only affect people living in Spain. The aim of the proposal is to complete the universalization of the health care system by extending to the 200,000 people who are currently excluded. EU residents are one of the three main groups affected which is why I thought it might be of interest.

There´s more info here;

Empty Deckchair

Since I posted the Government has announced it intends to publish its own proposals in October so more info should become available over the next few months.

I´m also wondering if there´s a catch here and it may yet get kicked into the long grass. The thing is nobody in national Spanish politics even attempts to defend the current system; it´s illogical and a bureaucatic/ legal nightmare. So I´m hopeful the changes will go through. If the Governments proposals are line with what has already been agreed, this would mean people living in Spain would have access to health care as a right of residence.

[Rob1305]

It is hard to believe given the current financial problems in Spain but would be welcomed by many early retirees. And of course ease the confusion and bureaucracy. The other forums don't mention it BTW.

[timr]

Yes, I´ll also stay sceptical till it actually happens. Although I have been posting the info on other forums over the last month, the reaction has been (understandably) quite disbelieving. The actual cost, however, is not as great is as first might appear - it is estimated at under 150 million euros pa representing under 0.5% of the Spanish health care budget. Personally, daft as it might seem I believe the Spanish Government might actually save money. Its not just that so few people are currently excluded, its also a question of who they are. The vast majority fall into three main groups; people of “independent means” who have never worked or needed to work, lawyers and EU residents. The first group maybe aren´t that interest anyway (private insurance ?) and the second group are lobbying like mad for the change and are capable of causing more trouble than its worth. Set against this is the cost of administrating a system which has become incredibly complex.

The problem is actually one of perception. Spanish people believe they actually already have a universal and free health care system. The only surprise is that there are still people excluded from it. The British people living here, on the other hand, are under the impression that the Spanish system is "contribution-based" and that this is somehow a huge transformation in the nature of the system. Actually it isn´t, it is simply the final stage in a project that was started as long ago as 1986. That is one of the reasons why this initiative has received so little attention in the Spanish press. The other, I believe, lies in the groups affected. The extension of free health care to the wealthy, lawyers and British expats is hardly a vote winner.

[timr]

Hi, for the folks who are interested in these changes, here´s a link to an article on the front page of this mornings El País. The Government will introduce legislation in November to complete the universalization of health care. This has already been agreed with the PP as the first point in the "Pacto por La Sandidad". Whilst details of the legislation aren´t as yet public, the proposals agreed previously have always included foreign residents.

Miles de personas sin paraguas sanitario

[new nanny]

May I first say thank you for doing your homework on this subject, I think it will be a relief to many if this goes through without problems and cost !!! After reading the link above, am I right in thinking that some of the Spanish people have the same problem as myself, which may I add came as a shock. After paying into the system for 16 years on autonomo I have been told I have half the rights of the workers with a contract, and I am expected to get private health insurance. For many years I have payed to be advised on doing things legal and now this seems to have cost me far more money and no health cover, unemployment payments etc. I am now asking myself, why pay for advise and be told to be self employed, which costs far more per month ??? get a contract job if possible !!! no wonder theres so much black money around and no one wants to pay into the system..... keep up the good work ... I for one will be watching !!!!

[timr]

Hi, yes you´re right - in a certain limited set of circumstances people do not have the right to public health care. The article in El País is about the Governments plans bring everyone within the system. Additionallly,the system is now so complex, people are confused over how it works. From reading posts on Spanish forums, some funcionarios are not "helping" people thru the system and, consequently, they are losing their health care when they don´t need to. This is a not about about "rights" as such but administrative failure. Here´s link to a section of the blog which explains the process in general terms when someone becomes unemployed (as far as I can undertand it !).

Do unemployed people lose their health care in Spain? | Empty Deckchair

I´m assuming you live in Valencia ? If so the good news is that the Regional Government passed a law in 2008 which extends the health cover indefinitely for anyone "en baja" from any of the Social Security regimes. From your post, I hope this may apply to you.

Here´s name of the law;

Ley 6/2008, de 2 de junio, de la Generalitat, de Aseguramiento Sanitario del Sistema Sanitario Público de la Comunitat Valenciana;

Here´s a link;

Ley 6/2008, de 2 de junio, de la Generalitat, de Aseguramiento Sanitario del Sistema Sanitario Pblico de la Comunitat Valenciana.

Here´s the relevant section;
Capitulo IV, Articulo 9 where cover is maintained for;

"Afiliados a la Seguridad Social en situación de baja de cotización por cese en la actividad laboral en cualquiera de sus regímenes, y los beneficiarios de los mismos."

I´d talk to the functonarios local Health centre and ask them if you qualify. From your post and what I understand of the background to this, this law was intended specifically so people like yourself do not lose their health care.

Please post again and to say how you´ve gone on. That way I can write a section up on the blog with some step by step instructions. Its happening to Spanish people all time, so I´m sure there must other Brits with same problem.

Good luck.