Every day 35 people from Tarragona go to private healthcare. There are 25,600 in two years, since Covid-19, according to data in the province that has now been released by Unespa employers, and which also includes the impact of this trend during 2021, the second year of Covid-19. The pace did not slacken in that year, where the upward trend has been perpetuated: in the two years of health emergency, the subscription of these insurances doubled compared to the previous period.
The explanation is easy and logical: the coronavirus has further complicated the difficult situation that the public health system is going through, reflected, for example, in the waiting lists for an operation or a visit to a specialist. Tarragona, where the penetration of policies was already important, has been particularly affected by inertia. It is the Catalan province with the largest increase in affiliation (12.7%) in two years, far surpassing Lleida (7.1%). But, in turn, the counties of Tarragona stand out in terms of the state. It is the sixth province of Spain in population with private health insurance. 27.69% of citizens had a mutual in 2021. A year earlier the figure was 26.7% and if perspective is taken the difference is even more marked. In 2011, ten years earlier, there was 20.7%.
The list is commanded by the most populated provinces, Madrid and Barcelona and, from there, only the Balearic Islands, Vizcaya and Malaga appear ahead. In this context, an inevitable debate arises. For some, going to a mutual reveals shortcomings and poor functioning of the public; for others, it is a complement. “The health needs of a society are very extensive. Meanwhile, the available resources are limited. For this reason, it must be borne in mind that public and private healthcare are not rivals, but rather complement each other”, explains Unespa.
Looking for a quick medical solution in times when healthcare has been saturated by the virus is not the only factor. “Medical insurance is successful because it is products that are marketed at competitive and accessible prices, the available offer is wide and has differential characteristics,” says Unespa, which adds: “Health insurance offers innovative treatments. They allow to have complementary therapeutic options and access to the specialist quickly, they offer complementary coverage such as oral care or they usually have coverage abroad. All these advantages have motivated, according to Unespa, “the sustained growth of health insurance billing in the last three decades.”
The sector takes pride in its contribution to the pandemic: «The contribution of the private health system to the National Health System has been revealed during Covid-19. The insurance sector has facilitated access to care for coronavirus patients. It has also financed diagnostic tests for millions of people in Spain. The insurance has contributed to the containment of the pandemic in the country.”
Having a policy changes the behavior of the citizen towards health, because in general lines he stops going to the public. That is seen by some as a way to decongest. “These are attentions that the public health system saves. Those who take out insurance, although they can go to the public one like any taxpayer, go to the private one and thus alleviate the workload of public centers”, adds Unespa. There are those who defend that, just as someone decides to pay for a specific service, there are also those who prefer to subscribe for greater accessibility to the system.
What is clear is that it is very difficult to separate the most intense boom in mutuality in the context of SARS-CoV-2. “Consultations and operations have been postponed, and there is a part of the population that has opted for other ways,” summarizes Dr. Mireia Garcia-Villarrubia, vice president of the Official College of Metges of Tarragona (COMT).
“Segregation is generated”
The trend is global. In Spain, the number of insured has grown by almost 9% since 2019, below the percentage in Tarragona (12.7%). In the last year, the increase in Spain was 4.5%, somewhat higher than the figure for Tarragona (4.3%), which in turn exceeds the Catalan average (3.21%).
Some voices are critical. «In the end we reach a situation in which whoever has money can pay for health care and whoever does not is excluded. segregation is generated. People seek life and do so by paying, which will increase inequalities and make differences grow. People are stigmatized and as a society we have to consider it”, explains Marina Roig, delegate of the staff board of Joan XXIII. Roig adds: «There has always been private healthcare and there always will be, because there are people who want access. What cannot be is that you do it because the public does not work. I can buy a Porsche if I want, but I have to be able to have a minimum, a much cheaper car to move around. For the union delegate, “the Covid has shown that the mutuals have not known how to give any type of exit until they started doing PCR” and condemns that “taking out insurance is almost an obligation to have a minimum quality service”.