The Government withdraws the copay for prostheses and wheelchairs for the most vulnerable

A couple pushes the wheelchair of a family member down a street in Seville. / REUTERS

The law prohibits charges for other health services, shields public management and guarantees free and immediate assistance to emigrants and without papers

Alfonso Torres

The Council of Ministers approved this Tuesday the draft Law on Equity, Universality and Cohesion of the National Health System (SNS). It is the rule that seeks to shield health centers and hospitals against direct or indirect privatization, that restricts concerts with private health, that removes the last bureaucratic obstacles so that any person, national or foreign, receives care under equal conditions that the rest, which abolishes part of the co-payments established by the PP Executive in 2012 and, above all, which will prevent new charges from being set for citizens for health benefits, whatever they are and wherever they live.

The project, once it becomes law with its debate and approval by Congress and the Senate, will exempt the most vulnerable Spaniards from the co-payment for orthoprosthetic products, such as prostheses or wheelchairs, and for the use of non-urgent medical transport , the six million citizens whom on January 1, 2021 the Government already released from paying for the medicines they consume, a percentage that they paid since the Executive of Mariano Rajoy decided so.

The future norm has already received criticism from private health employers, who believe that it will make Spain the first European country that prevents the contribution of private centers to the sustainability of the system. They see in the norm a direct attack on a sector that, they say, absorbed 30% of hospitalizations during the pandemic. His lamentations are just the opposite of those of United We Can, which despite its status as a government partner did not hide that it considers the law insufficient, because it understands that it will not prevent the privatization of health services. These are some of the points of the bill.

Those exempt from copay

The groups that will be exempt from co-payments if the law is approved in the current terms are pensioners with incomes of less than 5,635 euros or who do not pay personal income tax for having an income of less than 11,200 euros per year, the families of minors affected by a disability of 33% or higher, the beneficiaries of the Minimum Vital Income and the recipients of the non-contributory benefit for their dependent child or minor. They will join the citizens who are already exempt today: the unemployed without a subsidy or benefit, the recipients of non-contributory pensions and some specific profiles of patients.

What will they stop paying?

The prosthetics and orthotics copay applies to all types of external prostheses, such as limbs, joints, face or mouth; to orthoses (corrective structures) of the spine, hands or feet; to orthopedic footwear, wheelchairs, walkers or canes, and other elements such as compression bandages or hearing aids, among others.

Reject new copays

It sets as its goal the progressive reduction of current co-payments (pharmaceuticals and orthoprosthetics) and shields public health and its users against the future temptation of some other political leader to establish new charges for services or products.

Changes the royal decree law with which the Executive of the PP divided the portfolio of public health services into three to be able to set co-payments in one of the blocks. With the reform, the portfolio of common services of the National Health System (SNS) will once again be unique in all of Spain, regardless of the autonomy that is lived.

The private one, only “exceptional” use

It expressly repeals the 1997 rule by which the Government of José María Aznar made possible new forms of management of the SNS, which allowed the privatization of public health. With the approval of the law, the general rule will be public and direct management of all SNS centers and services. Any indirect management or agreement with private companies must be something "exceptional", complementary and it must be explained why the service is not possible from the public. State and autonomies will agree on the specific indicators that will authorize these exceptions.

universal assistance

Any person who is in Spain, whether national or foreign, whether or not they have their papers in order, is guaranteed by law the right to receive the health care they require free of charge, immediately and without any administrative obstacles, under the same conditions and with the same scope as the national ones. The norm explicitly guarantees this attention to the undocumented, to Spaniards who reside abroad but come to visit, to those who benefit from international protection and to victims of trafficking.

Citizen participation

The law makes the direct participation of citizens in the evaluation of the SNS and in the debate and proposal of health policies stable. They will do so through the presence on the advisory committee of representatives of associations for patients, the disabled and professional associations.

Children's fillings reach public consultations

he Council of Ministers also approved this Tuesday the Oral Health Action Plan which, with an endowment of 44 million, will benefit some seven million people in Spain. It establishes as priority groups children from 0 to 5 years old and from 6 to 14 years old, pregnant women, people with intellectual disabilities and disability that limits the mobility of the upper limbs, and those diagnosed with oncological processes in the neck and face.

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