These will be the increases in regional spending if public health abandons private agreement

Reform of the National Health System


The communities will be forced to assume an extra cost for the services that they now carry out with the collaboration of the private company of 2,700 million euros, increasing that expense to 10,000 million euros, according to an IDIS report.

The health reform that the Government intends to carry out in the parliamentary process of the bill that modifies various regulations to consolidate the equity, universality and cohesion of the National Health System (SNS) and that eliminates private collaboration for the provision assistance, with exceptions, it may mean an increase in health spending of 2,700 million euros that the different health services will have to face, reaching more than 10,000 million euros.

This would occur if, as the government partner intends, United We Can (UP), manages to convince the socialists to restrict to the maximum the exceptionality of arranging services with private entities, de facto breaking that collaboration almost entirely. And it is that UP aspires to include in the process of amendments to the bill that exceptional outsourcing does not last more than one year, that in no case is it deployed for the management of hospitals or health centers and not extend health agreements with the private sector.

Is the public system, transferred to all the autonomous communities, prepared to assume all the benefits without the collaboration of private entities through concerts?

According to the report of Institute for the Development and Integration of Health (IDIS) regarding what the private sector contributes to the health system, this shielding public health would have direct effects on care (increase in waiting lists, average times and hospital occupancy) but also on the costs that the different services should assume of autonomic health An amount that in the best scenario, according to the IDIS analysis, it would amount to 1,200 million euros. That is: The absorption of this activity by the public system would suppose an increase in the cost of around 800 million euros derived from the stays and 306 million euros from the first, successive and high-resolution consultations.

Expenditure by Autonomous Community

To these figures should be added, in addition, an expense of 60 million euros for nearly 800,000 diagnostic tests such as mammograms, nuclear magnetic resonance imaging, computed tomography, ultrasound and monitoring. Holter assumed until now by private-public collaboration.

Derived from the activity associated with treatments such as hemodialysis, in addition, The Institute estimates that the public system would have to take charge of more than 260,000 hemodialysis sessions, which would entail an additional cost for the public system of 24 million euros.

As indicated by the IDIS, the health expenditure dedicated to concerts with private entities published in 2020 amounts to 8,500 million euros, representing 10% of the total health expenditure (90,317,000,000 euros). Thus, with the total absorption of activity that is now concerted, the increase in spending could be around 2,700 million euros, if it is assumed that the total cost of benefits is 25% higher in the public system, the report points out.

That amount, added to the 8,500 million that are already disbursed from the regional administrations, would make health services saw their spending on all these benefits increase to more than 10,000 million euros.

Spending by specialty

In the case of hemodialysis, For example, the regional services would have to start by equipping their centers with rooms, with the necessary infrastructure for treatment, and hiring the pertinent personnel. Currently, and with data from 2020, all health services, except La Rioja and the Basque Country according to the IDIS report, have arranged this service for which they disburse more than 389 million euroswhich would be increased by the breakdown of that private collaboration. Only Catalonia devotes 117,326,048 to hemodialysis arrangementsbeing the community that allocates the most to this benefit.

The contracting of transport is another of the sections in which the autonomous communities have outsourced the service, according to the information provided by the IDIS, except for the Valencian Community. They allocate almost a billion to this, with the Catalan autonomous community once again allocating the most to this service, around 344,467,520 euros.

Respiratory therapy is another of the benefits of the health services that is done, in most regional services, through concerts, except in La Rioja, the Community of Madrid, the Basque Country and the Valencian Community, according to the same report. The autonomous communities allocated almost 166 million euros to this in 2020, with Catalonia in the lead (40,407,241 euros).

With these figures in hand, one would expect that parties such as ERC, PdCat and Junts (these last two have presented amendments to the entire project) show their opposition to the project that tries to shield public assistance, since it means giving the shatter models that have been ingrained for years, in the case of Catalonia, more than a hundred, and that work with 35% of care provision by direct or administrative public management entities (Catalan Institute of Health-ICS) and 65% , by public entities (consortiums and public companies) and private entities (religious orders and foundations, all non-profit) with company management.


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J. A. Allen

Author, blogger, freelance writer. Hater of spiders. Drinker of wine. Mother of hellions.

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