Crossfire of appeals

The one-euro-per-prescription fee, which is already in place in Catalonia and the Madrid region, has led to a rare coincidence: both the Popular Party (PP) and the opposition Socialists (PSOE) have filed appeals against its constitutionality. But that is where the parallel ends, because the reasons put forward by the two parties in their attempts to overturn the new regional tax are very different. For the PP it is a matter of preventing a new instance of regional encroachment in an area of national government power; i.e. pharmaceutical policy. Besides which, the measure generates obvious inequities between one region and another. The PSOE, meanwhile, is using arguments of inequality, given that a region governed by the party - Andalusia - has set up a system of pharmaceutical auctions on a wholesale level, to reduce the final cost of medicines for the public. The central government has appealed against this.

Political reasons have led both parties into certain contradictions, such as the fact that the Rajoy government is rejecting a measure that taxes the consumption of medicines, when it has itself done the same by raising pharmaceutical co-payment and forcing even pensioners to pay their share. The euro-per-prescription is in line with the PP's policies in this respect. However, once it had appealed against the tax imposed in Catalonia by Artur Mas, it was obliged to appeal against the same measure applied in Madrid by a regional government of its own party for the sake of consistency.

The Socialists' rejection of a hike in the price of medicines is what now prevents them from going to the Constitutional Court to demand the equality that is supposed to be inherent in the system, since the Andalusian auction system already infringed that. Meanwhile, the Socialist leader in the Basque Country, Patxi López, has refused to implement the central government's co-payment system.

Political wrangling

Quite apart from such political wrangling, which suggests the extent of the serious problems that persist in the system of regional government, the objection to the euro-per-prescription fee is that it is a new tax of a linear and thus unprogressive nature, which lays a heavier burden on the sick, who have already been hit hard by the change in the co-payment system. The Madrid regional government of Ignacio González says that it is not so much aimed at collecting more revenue, but rather at "encouraging a more efficient use of medication," given the high consumption of pharmaceuticals in Spain. This government, which is embarking on the extensive privatization of hospitals and clinics, has once again prompted serious doubts as to its capacity to properly manage such an essential public service, given that it is not the patient but the doctor who prescribes medication and dosages. The fact that the euro-per-prescription charge has been put into place without a proper computer system to monitor the per-patient limit (72 euros a year) is yet more evidence that these measures are being improvised.