Luis Alberto Gallego Burguillo. Specialist in Orthopedic Surgery and Traumatology
With the unrelenting growth of health care spending in recent decades in relation to the gross domestic product of each country (which has been much higher than overall economic growth), along with cuts in public spending due to the recent economic crisis, the inability of national health care services to provide a level of coverage to meet demand has become obvious; to ensure the financial sustainability of health care systems, in different countries of the European Union transfers are being made in the public health care sector to private (as advised policies of the World Bank and IMF).
There are differences in the extent of health care coverage and the price to be paid for services between countries with different laws and organizational structures that affect their national health care systems and therefore also are reflected in the private sphere.
In Spain (according to the report Health at a Glance: Europe 2012), published by the OECD; there is a 74% public funding and 26% of private (20% direct payment and private insurance 6%). The average of the 27 EU countries was 73.21 and 4%, respectively.
Total expenditure in relation to GDP was 9.6%, while the EU average was 9%.
(The OECD advises caution as regards the data related to long-stay hospital patients given that the information system is still being implanted in some countries).
We must differentiate private funding for hiring private services from public money, as in our country, to carry through contracts for diagnostic tests, waiting lists for surgery, or the purchase of private services by public mutual societies as MUFACE, ISFAS, MUGEJU or private medical health care for work accidents.
There are several types of private insurance: compulsory, primary or substitutional, complementary and supplementary: compulsory private insurance cover for motor vehicle accidents and sports accidents by the relevant federations. Primary or substitutional cover cover people who are excluded from the public system; supplementary cover the same services as required but with faster access and increased choice (in Spain cover 19.7% of the population). Supplementary insurance cover costs excluded from compulsory care funding.
Direct payment ("out of pocket") payments represented 20% of health care spending in Spain in 2010, one of the highest in developed Europe. Here are some characteristics of other EEC countries (we are going to look at the biggest countries, those around us, and those with similar economic circumstances to ours, and also the most developed):