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Health costs

Spain should either drastically cut spending, drop free healthcare, or introduce a co-payment system

Spain's health service, which is administered by the country's regional governments, is in the red to the tune of 9.4 billion euros. Equally worrying is the speed with which it is increasing: the cost of covering prescriptions has risen by 10.8 percent on the first quarter of last year.

The amount that Spain spends on its healthcare system is far from exorbitant; it is below the EU average (of the 15 members before the bloc grew to 27), and comes in at around six percent of GDP. What is costly, for example, is the amount spent on pharmaceuticals, which puts Spain second only to the United States. Spaniards also visit the doctor eight times more on average than their fellow EU citizens.

Spain's healthcare costs have risen dramatically in recent years, and given the demands put on the system, it is hard to see how they can be reduced. The country's population has risen sharply over the last decade, while at the same time it has aged (the elderly require more medical attention). At the same time, it has struggled to keep up with new and ever-more sophisticated technology and treatment procedures. Quite simply, unless stricter controls are put in place, the cost of maintaining the healthcare system as it stands at the moment will continue to increase.

Funding the healthcare system absorbs almost half of Spain's regional government spending (44.9 percent); add education to the equation and that comes to 70 percent of spending. Add to that social services, and three-quarters of the regional budget is gone. The regions' mounting budget deficit is structural; but that doesn't mean that it cannot and should not be brought under control. It is an obstacle to fulfilling their deficit limits, and puts Spain at risk of failing to meet its stability commitments, while worsening the country's sovereign-debt crisis. It also generates abusive delays in paying suppliers to the regional governments, with Popular Party-run administrations being the worst offenders.

In short, this country faces a dilemma: either it drastically cuts the amount of money it spends on healthcare, reducing its scope, or, if it wants to maintain current high standards, it must cut back on non-essential services, and generate some revenue by introducing a co-payment system, whereby users make a financial contribution to see a doctor. Such an approach would obviously have to be done on the basis of the ability to pay. The solution to the dilemma ought to be obvious to all.

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