If Spain were Sweden, people older than 65 years who are entitled to a dependency aid would be 1.6 million, according to data from 2016. It would increase, therefore, the number of users with rights, currently punished by stinging evaluations that leave out many applicants, a scale that hardened with the crisis. The family care would be very residual because public services would be guaranteed, there would be more residential places, more day centers … But Spain is not Sweden. And the difference lies not only in public funding for long-term care, much higher in the Nordic countries -0.7% of Spanish GDP in 2014 compared to 3.2% Swedish-, but in the mentality of society, accustomed in southern Europe to place the care of the elderly on the shoulders of families, especially women. The question is: could a Swedish model be applied in Spain? A study commissioned by the Institute of Fiscal Studies, dependent of the Ministry of Finance, calculates that the Administrations would have to inject to the system some 7,200 million euros more (an investment that would suppose practically the double that at present), of which they would return to the treasury near 5,000.
The report -produced by economists Rosa Martínez, Susana Roldán and Mercedes Sastre- proposes a totally public and universal model. It was scheduled to be presented at an event on November 15, but finally the Institute of Fiscal Studies opted to publish it on its website, without further publicity.
In their analysis, the academics choose the population over 65 years and study the dependency model in Spain, where within three decades one out of every four people will be in this age group, according to the projections of the National Institute of Statistics. More than 12 million will have 65 or more, compared to around nine currently. In 2016, 10.3% of the population in this age group had some degree of recognized dependence.
The document also states that the system of the Spanish dependency is unduly overturned "towards the economic benefit for family care, conceived in the law as exceptional." Nowadays, Almost a third of the care is taken care of by relatives.
"We propose a system with public character, of a universal and sufficient coverage, in such a way that family members are not used to ensure the basic needs of daily life", explains María Pazos, who directs the line of research on public policies and equality of gender in the Institute of Fiscal Studies and has supervised the report.
The research, based on data from 2016, quantifies what resources would be necessary to meet the real demand. For this, they propose two scenarios. The first applies the current scale of assessment of the dependency to the results of the Survey on Aging, Health and Retirement in Europe (SHARE, for its acronym in English) and deduces the real needs for help. The second projects the Spanish panorama if the Swedish level of coverage were applied, a model used as a reference "given its leadership in social policy".
The report commissioned by the Institute of Fiscal Studies foresees a significant increase in the number of places in public residences in Spain. In the two models on which the report is based, there is an increase in the 113,000 public or concerted places that, according to the document, were enabled in 2016 for people over 65 years of age up to more than 400,000 public places.
This increase would require a budgetary effort, but those responsible for the report contemplate that the implementation may be progressive. "Demand will come with the offer," says María Pazos, supervisor of the study and director of the research line on public policies and gender equality at the Institute of Fiscal Studies.
"In Spain the residences have a stigma because the quality is low and they are like an anteroom of death, only the most serious ones go," he explains. "In Sweden the model is different, it changed in the sixties. In Spain perhaps a transition is needed, but it will also happen, as the offer is greater and of better quality, "he concludes.
With the first simulation, the researchers conclude that, taking 2016 as a reference, the actual number of dependents would be 1.2 million and not 894,000, as there was that year. With the second model, the Swedish, calculated from the percentage of population that has some coverage there, the figure would be even higher: 1.6 million people should have recognized the dependence in Spain.
To cope with this increase in users, the authors of the report estimate that it would take more than half a million full-time jobs, about 400,000 new jobs. The researchers estimate that in 2016 about 155,000 people worked in the system.
One of the keys to the study is the budget increase it collects to improve services and increase the number of users. They calculate that both models would require an investment of more than 17,000 million euros per year. The cost of care for those over 65 in 2016 was around 5,800 million euros. That is to say, become Swedish would imply a budget increase of around 12,000 million.
More than 7,200 million
In the proposal, the dependent faces a copayment for room and board in the residences or day centers – if he can not afford it, a State aid is proposed. Subtracting that co-payment, public spending would surpass 7,200 million euros in both models.
In addition, the proposal includes eliminating certain tax incentives associated with age, disability and dependence on Personal Income Tax, which amount to some 1,700 million euros. To these calculations should be added the return calculated in about 5,000 million in Social Security contributions of new employees and your taxes. "This only in direct returns. You have to calculate the indirect, there would be more people accessing the labor market and, therefore, more consumption, "says María Pazos.
"The accounts come out. The proposal is feasible. Maybe not at once, but with a progressive calendar, "says Pazos. "A change of model is proposed here, not an application calendar. Neither do we think how it should be financed, that the Administrations decide, "explains Mercedes Sastre, professor of Applied Economics at the Complutense University of Madrid and one of the authors of the report.
"Instead of the current system, whose fundamental pillar is the care provided by women in precarious conditions, this study proposes to universalize the right to sufficient and quality care by public services. The fundamental virtue of this work is to place the debate on the model of care that is required to meet the growing needs while ensuring the rights of all the people involved, "continues Pazos. "This requires a pact from the public authorities involved," he adds. "The problem is not just how much is spent, but how it is spent. And in Spain it has been spent very badly, "he concludes.