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Healthcare in crisis 06 - 12 JULY 2012
by jack troughton
PENSIONERS CONTROVERSIALLY began paying for prescriptions last Sunday despite warnings health cuts could spark a “humanitarian problem’. For the first time since the creation of the modern Spanish Health System in 1986, retired people have been hit with charges for medicines while workers will also pay more – all dependent on income. The co-payment system is just one of a raft of changes announced by Mariano Rajoy’s government in April and is aimed at saving seven billion euros. Other cuts include the withdrawal of free medical care for illegal immigrants and a series of “efficiency measures” including a clampdown on health tourism. British state pensioners resident in Spain will also be hit with prescription charges for the first time. In a reciprocal agreement, the UK government pays £3,500 a year for each retiree to receive Spanish health care – which entitles them to the same care as a Spanish citizen. However, expats were caught by surprise when they took prescriptions to pharmacies this week and for the first time were asked to pay 10% of the value of the medicines. The charges are levied as follows: • An annual income of under 18,000€: workers pay 40% of prescription charges; pensioners 10% capped at 8€ per month. • An annual income of 18,000€ to 100,000€: workers pay 50% of charges; pensioners 10% of charges capped at 18€ per month. • An annual income of over 100,000€: workers pay 60% of charges; pensioners 60% capped at 60€ a month. The long term unemployed, disabled people, and people being treated for alcoholism and drug addiction will not be affected. Pensioners who accidently pay above the monthly ‘ceiling’ will be able to claim the ex-
cess money back from the government. Spain’s 8.5 million pensioners are said to be responsible for 75% of the 11 billion euro spent on drugs – some 1.1% of gross domestic product – and are expected to be hit hard by the changes, especially during the current recession. Madrid maintains the changes are the only way to maintain the welfare state but critics say the co-payment system is a tax on disease. And one Minister said: “It’s time we end the culture of everything for free.” In an article in the highly respected medical journal The Lancet, paediatrician Marciano Sanchez Bayle, a spokesman for the Federation of Associations for the Defence of Public Health said: “It punishes those with more limited resources and more health problems. He said 8.5% of Spanish pensioners earned less than 300€ a month and 54% of retired people had less than 650€ a month. “It puts them in a position of choosing between paying for medicine or buying food.” The doctor said the raft of changes “is a humanitarian problem for public health” and the FADSP predicts the cuts as being “weather balloon to gauge response” before wielding the axe again. Les Power, from Jalon, admitted he was caught out when he popped into the chemist and was told the medicines would cost him 3.50€. “I thought it was surprising because I had not seen anything written in the English press – I thought it would be headline news.” He said it appeared the Spanish government was ”pinching” money from pensioners – including the contribution sent from the UK. And he asked how the surgeries and pharmacies could keep tabs on each pensioners spending on medicines to make the system work. “It all sounds as if they are operating a system that will cost more to run than the savings it will make.” continued on page 13
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