Spain considers charging for health care to help plug its financial deficit

The Spanish government is considering introducing a fee per visit for publicly funded healthcare services in a bid to help plug the hole in its finances. Health authorities in various autonomous regions like Catalonia, Valencia, Madrid, or Asturias, have backed this approach in the past few weeks, despite widespread opposition.

The campaign group, the Madrid Network Against Privatisation of Public Health Care (CAS Madrid), states that the treasury is studying the feasibility of implementing a fee per visit system. The various options under consideration, it says, include charging 2 to 3 euros to see the family doctor or the pediatrician, and a financial penalty for anyone requesting emergency services for non-urgent care, in the view of the attending doctor. Other options include requiring pensioners to pay a proportion of the overall cost of drugs around 10% for those with long term conditions, or on a sliding scale, depending on income-and simply not providing certain expensive services for free, forcing patients to either pay for them privately or to take out insurance cover. "There is evidence that a fee per visit reduces both necessary as well as unnecessary visits, and it is indiscriminate: the repercussions are worse for those who have lower incomes and for marginalised groups," commented the spokesperson for Dempeus per la Salut Pública (Standing Up for Public Health Care).

 

Source: BMJ 2010;340:c3063