Three reasons to hire health insurance. The death of her husband in 2015 after being given an appointment in public health at 18 months and infected during chemotherapy (Tina, 65 years of age). Heartburn and reflux that made it unbearable to wait more than four months for a gastroscopy in 2012 (Pablo, presumed name of a journalist of 41). Sensation of helplessness to suffer symptoms similar to those of his father, who died of a fulminant cancer in 2017 (Amanda, graphic designer of 36).
There are other less dramatic causes. Do not opt for age and waiting list for a fertility treatment in the public (Ayala, assumed name of an administrative and student of 41 years). Do a favor to the bank manager (Ismael, rancher of 49). That your company pays for the policy (Alberto, engineer of 38). All of them have stayed. For the same reasons. The ease of seeing the doctor a few days after the back pain appears, a suspicious lump appears or touches the gynecologist's revision.
After the drastic cuts in public health ordered by the PP in 2012 – with the increase of the pharmaceutical copayment in terms of income, including pensioners, exclusion of immigrants and a drain of 20,000 workers in two years, among other measures, the Government intended to save 7,260 million – and while the economy drew negative graphs in the winter of the recession, health policies did not stop growing until reaching the 11.5 million people covered in 2017, one million more (10%) since the great snip. That means that one in four Spaniards can go to private health insurance under cover of insurance.
Today, one in five households has health insurance, with an average expenditure of 1,186 euros per year, according to INE data. These policies pulled the sector with a 5.6% growth in 2018 and a turnover of 8.520 million. Part of the subscribers of these policies have had bad experiences in public health. During the years in which the investment collapsed, as of 2012, decreased the satisfaction of users of the large public health coverage umbrella, while the waiting lists grew. It did not even reach 6.5 out of 10, a figure that did not recover until 2016, coinciding with the ascending money curve.
The main agent of the contract is the deterioration, they say in Facua
Javier, an engineer with progressive ideas, felt discomfort in his stomach in the summer of 2013. At the end of the year he went to the doctor. "They gave him an appointment for the specialist in mid-2015!" Recalls Belén, his daughter. "He was a great supporter of public health, but I could not explain it to him." In an emergency admission in a large hospital in Madrid, he was diagnosed with stomach cancer. "They gave him chemo in the oncology plant. There was dirt and he got infected with bacteria. The nurses themselves encouraged us to take pictures and share them. " The daughter spread on Twitter images of the accumulated crap on the window ledge, in the sink's silicone or the shower tray. "My mother, Tina, wanted to get him out of there, but he told us, 'No, that's what they want, neglecting everything, let's go.' Javier went to die in a private clinic, resigned, one month before the first appointment he had been given in public health. "Then my mother made a very complete insurance to my sister and me."
"The main agent of the hiring is the deterioration," says Rubén Sánchez, spokesperson for the consumer association FACUA, "the saturation, waiting lists and benefit cuts push to register in insurers." The Federation of Associations for Public Health (FADSP) offers a similar reading. "The degradation of the public system, PP strategy, leads people to double coverage, a private specialist to skip the waiting list," observes the spokesman, Marciano Sánchez Bayle, "but then all the surveys say that if there is a Fat problem, they go to the public. "
"We run the risk of there being two speeds in access to healthcare," Juan Oliva, former president of the Health Economics Association and professor at the University of Castilla-La Mancha, warns, "a fast track, the one of those who They have private insurance, and a slow way for those who do not. Public health is a very solid institution, but if part of the citizens abandons it, it will break down and deteriorate. "
Precisely the quick access to the consultations of gynecologists or ophthalmologists, for example, is the big asset of insurance. If they could choose, 37% of Spaniards would go to a private specialist, according to data from the Ministry of Health. The Barometer of Private Health notes that 74% of the insured have gone to the specialist in the last year, and half have used it to get some test. The percentage decreases in visits to the family doctor, emergencies or income (14%, the least used service).
As a result of suffering pains in the abdomen, Alberto, the engineer from Madrid, has been through three specialists since November, and he has already had four tests. "Imagine what it would have taken in the public," he says. If I lived in the Canaries, I would wait 105 days; If he lived in the Basque Country, 22, according to the latest official data. Between these parameters the communities move. Although the contracting of policies is not correlated with the waiting lists. Madrid and Vizcaya, with good data, have an insurance penetration percentage of more than 40%. On the contrary, in Murcia, with 53 days of average waiting to see the specialist, that protection is hardly contracted.
"It's a model that complements, comfort is sought," says a directive
"When you are bad you worry and your morale goes down, you do not want to wait," says Ayala. He had a lump in his back and in the public the surgeon told him not to take it off. "In the private I was removed in a week." Above all, she appreciates the tranquility with which she feels attended. Ismael, the farmer from Extremadura, soon realized that he would renew his insurance: "I had an appointment in the public for a diagnostic test a year and a half after having surgery for a serious bone infection."
Private sector sources do not directly relate to cuts and growth of the policies. "Most of us think that we have an excellent public health," says Ángeles Milla, Health Director of Axa, "with private insurance, which is a complementary model, we look for comfort and capacity of choice". The directive adds that these products have become very affordable and with great customization capacity. "They have stopped being a luxury". "A health insurance gives you access without waiting for the doctor of any specialty among other advantages," says Iñaki Peralta, general director of Sanitas Seguros, the second company in market share, "and companies invested in improving the customer experience. " Peralta talks about the possibility of obtaining with the mobile until video consultations. The employers of insurers Unespa maintains that the growth of the policies is due to the fact that "companies and SMEs offer them as a social benefit, the one most valued by employees. It is a talent retention tool, "observes a spokesperson. Peralta and Milla corroborate what the data reflects.
Companies are deducted the amount of the policies for workers
"What is not said is that companies deduct the insurance they hire for workers," says the Fadsp spokesperson, "whereupon, we are all financing private insurance." In addition to the tax benefit, if possible, for the employees, who find it cheaper to contract the policy, the companies deduct 100% of the amount contributed in the corporate tax. On the other hand, almost two million officials choose private policies against the national health system. "That model should disappear and integrate everyone in the public," continues Sanchez Bayle, "because the State pays for it"
Pablo endured more than four months for a gastroscopy, while the white tide, in 2013, cried out against the cuts. That led to the private one. Amanda joined the insurance offered by her company because she was afraid. His father had died in three months of a cancer with a genetic component. Soon, he felt the same discomfort that he had. The doctor did a fecal occult blood test. He did not stay calm. He decided to go to a private specialist. "As I started talking, he sent me a gastroscopy and a colonoscopy, an analysis that afternoon and a test of intolerance." Nothing. "But he saw me twice until the treatment worked." Unnecessary or not, those tests reassured him. Both she and Pablo were proud users of public health. Until they stopped being it.
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