The Government sends its law to Congress to prioritize the public management of health and eliminate co-payments

The Government, after approving it in the Council of Ministers on Tuesday, sends its bill to prioritize public health management, eliminate co-payments for vulnerable groups and close bureaucratic channels to exclude immigrants from the system.

The Government recognizes that its universal health decree does not work and prepares another law to guarantee the assistance of undocumented immigrants

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The text is called equity, cohesion and universality and addresses different aspects. On the one hand, it plans to make the direct and public management of the health system a priority. This affects the concerts with private entities to which the autonomous communities –which have the powers to provide the service to the citizens– resort to serve the citizens to different degrees.

Between concerts, center management concessions and mutualism, 10% of the money allocated by the administrations to health goes to these models, according to the Idis Foundation, which brings together private health companies. In Catalonia, concerts account for 24% of the public health budget, in the Community of Madrid 9%, in the Balearic Islands 9.2%, in the Canary Islands 7% or in Andalusia 4%.

The Minister of Health, Carolina Darias, has affirmed that the law “shields public health”. The articles, according to Darias, "establishes the exceptions for indirect management that will be complementary and supportive." The minister has indicated that this possibility should be applied "only when direct management is not possible." And to use it, the responsible administration "must meet a series of requirements such as the optimal use of its resources, the insufficiency to be able to carry out the assistance and the need to resort to indirect formulas". The Interterritorial Health Council must develop a series of indicators to meet these criteria, added Darias.

Podemos has already made progress when the draft bill was presented in November 2021, which sought to amend the text in its parliamentary procedure because, they considered, the text does not eliminate the privatization of health. "It is time to close the door on this conception of health as a business," they said.

Another of the legs of the project is to eliminate certain co-payments to vulnerable groups. It would be about removing the obligation to pay part of the non-urgent transfer and prosthetics for people who receive the minimum vital income, minors with disabilities, low-income pensioners or people with a meager income and children in their care. The copay would be eliminated by incorporating a list of products in the basic portfolio in charge of public budgets.

The third area that the future law will modify is access to healthcare for groups of immigrants. The articles, according to the Ministry of Health, seek to "guarantee homogeneity in the effectiveness of the right to health protection and expand the rights of the population currently not included." This should include foreigners regardless of whether they are in a regular or irregular administrative situation in Spain. The decree approved by the Government in 2018 to reverse the exclusion established in 2012 by the Executive of Mariano Rajoy left back doors open.

The writing of this text allowed some cracks through which, in practice, different regional governments have imposed obstacles administrative access to care.

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