One million Spanish public workers see their medical coverage reduced

Insurers cut lists of doctors and hospitals covered by Finance Ministry’s Muface system

An ambulance outside a hospital.
An ambulance outside a hospital.David Rodríguez

Cuts in the number of hospitals and doctors paid through the Finance Ministry’s health insurance system Muface could affect about 1.5 million people – one million civil servants plus around half-a-million benefiting family members – who stand to lose medical coverage this year.

The insurers that take part in the Muface mutual society– Adeslas, Asisa and DKV – said they would no longer reimburse fees to as many doctors and hospitals, forcing many patients who get specialized care to change medical center or seek authorization for every test or consultation they need.

This was the case of a government worker who had been covered for 34 years by Muface. He was diagnosed with lung cancer at the end of 2013 and underwent surgery at HM Sanchinarro Hospital in Madrid. His coverage was handled by Adeslas.

This situation is creating uncertainty and uneasiness among sick people who don’t know what to do” CSI-F union secretary Eliseo Moreno

In November, when he went to make an appointment for his next check-up, he was asked if he was covered by Adeslas or Adeslas Muface.

“We don’t take Adeslas Muface any more,” the patient was told. After much haggling with the insurer, Adeslas agreed to continue his treatment for one more year.

“This isn’t just any type of illness – it is cancer. And it is causing me a lot anxiety and uneasiness,” he said.

The CSI-F government workers’ union has given the Finance Ministry until February 20 to explain the cutbacks in services.

“This situation is creating a lot of uncertainty and uneasiness among sick people who don’t know what to do because there is little information,” said CSI-F secretary Eliseo Moreno.

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Each year, government workers can chose whether they want private health coverage or prefer the public health system.

A Finance Ministry spokesman denied on Tuesday that cutbacks had been made. “It is very much the opposite,” the spokesman said, adding that the ministry had allotted 0.8 percent more, or €1.002 billion, to pay for insurance premiums.

But Moreno said the budget had been frozen since last year while at the same time the valued added tax (VAT) rate on healthcare rose from 10 percent to 21 percent on January 1, which has raised the price of services.

“For years, the insurance companies have been warning that they were going to cut their lists of doctors and health centers,” he said, adding that behind it was the aim to get rid of the Muface mutual society model of coverage.

Adeslas sources, meanwhile, said that for years the insurance premiums collected through the antiquated Muface fund were insufficient to pay for a higher demand in health services. Other insurance companies have been gradually reducing their lists of doctors and services, they said.

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