lack of funding The General Reciprocity of Civil Servants (MUFACE) chronicle already means a deterioration in healthcare – a serious situation when it comes to specialties such as Oncology – and has led to a reduction in the number of civil servants Those who prefer private healthcare. But also, If MUFACE falls due to lack of funds – the model currently saves the State more than €890 million a year – the impact on the private sector will be huge: 19 provinces will see a “serious risk” of hospital closures, most of them Castilla-La Mancha, Extremadura and Castilla y León. AND will disrupt public health: Echo There will be a 266% increase in the waiting list for external consultations and 115%, surgical.
This is stated in the report ‘Administrative mutualism: Selection of mutualists and a forecasting model of future scenarios’. Made within the framework of Chair of Sustainable and Responsible Health at the Complutense University of Madrid and was driven away with it Spanish Private Health Alliance (ASPE), comprehensive report presented this Wednesday on FMadrid Ministry of Commerce and Tourism At an event opened by the Dean, María Francisca Blasco López.
With data from MUFACE
The document defines administrative reciprocity as a coverage mechanism of the Special Social Security Regime consisting of MUFACE. General Judicial Reciprocity (MUGEJU) and the Armed Forces Social Institute (ISFAS). The report is aimed at an “in-depth analysis” of MUFACE, as it is the only partner to have collaborated through contribution in the preparation of the report. from data to assistance to authorities.
This is the second study launched by the Complutense University Chair for Sustainable and Responsible Health in 2022. With support from ASPE– actions related to the health sector (the first one was related to insurance). Presidency Director Ana Rosado stated that the document provides abundant and detailed information “at a critical moment when it is necessary to know what is happening in mutual communities.”
MUFACE reached nearly 1.5 million associate members in 2022; 70% of them were owners and 30% were beneficiaries
Because, as Herminia Rodríguez, vice president of the private healthcare employers association, puts it, “We are concerned about the current situation” and medical providers are seeing “their bottom line compromised,” meaning some centers Doubt as to whether service delivery will be maintained in mutual societies. This, he added, led to a loss of quality in care, particularly a “serious” loss of quality. Oncology case.
The first drawing of MUFACE: Reached nearly 1.5 million associate members in 2022Of these, 70% were owners and 30% were beneficiaries. In the last 10 years, total number decreased by 5.1%; Although there was a 5.5% increase in the number of shareholders in the 2013-2022 period, the reason for the decrease in the number of associate members is; Due to a 23% decrease in the number of beneficiaries.
The most mutualistic provinces
The study provides geographical data: The five provinces in Spain with the highest mutualism presence are: Madrid (16%), Barcelona (7%), Valencia (6%), Sevilla (5%) and Malaga (4%). The five least represented countries are Álava (0.2%), Soria (0.3%), Ceuta (0.3%), Melilla (0.3%) and Teruel (0.3%).
Associate members are 55% women and 45% men, and the average age of owners is 57.2.
Regarding the characterization of the owners, Who will decide the type of health service to be received, Women represent 55% of associate membersmen make up 45%. The average age of owners is 57.2 years, which increased by three years during the period studied (2013-2022).
Beneficiaries
Also the percentage of retired associate members increased by 9.2 percentage points in the last 10 years, It will increase from representing 29.1% in 2013 to 38.3% in 2022, fragments the document. The number of beneficiaries has decreased significantly: from 0.59 beneficiaries per associate member in 2013 to 0.43 registered in 2022. Most of the owners are Group A officers.
Associate members can choose each year between receiving their health care through the public or private system. The proportion of those who prefer to receive private assistance is 72.9%, while the proportion of those who prefer the public system is 72.9%. This figure is over 90% in ISFAS and MUGEJU.
Despite the “deterioration” suffering in recent years public health care and “the resulting increase in waiting lists” refers to the percentage of MUFACE associate members who opt for private assistance in the document decreased by 9.2 percentage points in the last decade. While it represented 81.9% in 2013, it increased to 72.9% in 2022.
Founding
Regarding the financing of the modelThe estimated public health expenditure for 2023 is 1,608 euros. MUFACE’s weighted average premium is 1,014 eurosThus, it was noted that the difference of 594 euros per associate member and year was “very significant”. If this difference is applied to all mutualists (MUFACE, MUGEJU and ISFAS), it is calculated that the mutualism model contributes. The state will save more than 1,000 million euros annually.
While public health expenditures increased by 54.3 percent in the 2014-2023 period, the increase in MUFACE premium was only 31.4 percent.
In addition, the report emphasizes that while a 54.3% increase in public health expenditures was recorded in the 2014-2023 period, the increase in MUFACE premium was only 31.4%, which represents a difference of 22.9 percentage points. On the other hand, it is estimated that it has happened in recent years. Insurers passed on only 50 percent of premium increase to large healthcare providers such as hospital groups.
What if MUFACE disappears?
The document presents one future and two scenarios. The disappearance or continuation of MUFACE, as stated in the press conference where the report was presented, Significant changes are needed. Sonia Juárez, teacher ICC’s business organization departmentwarned: The pressure is increasing due to the aging of the population or the increase in chronic diseases.
“It’s not sustainable; Must be completely replaced within two years at most. “As insurance companies and unions have warned in recent months, we must find a quick solution,” he said. the model does not have larger financial equipmentHe added that “additional financing from mutuals should be considered.”
Bankruptcy
In the first scenario, it is estimated that the insurance industry will stop issuing invoices in case of bankruptcy. More than 1.7 billion euros per yearcorresponds to the volume of administrative reciprocity premiums (in 2022), which represents accounts for approximately 14% of its turnover.
If MUFACE disappears, private hospitals in 19 provinces, especially Castilla-La Mancha, Extremadura and Castilla y León, face a “serious risk” of closing
Private hospital providers will stop billing for around €1,000 million, representing around 8% of the sector’s total billing. The disappearance of the model means that mutualists A total of 2 thousand 41 beds will remain vacant in the private hospital network at the national level.
In the event of this hypothetical disappearance, the degree of impact varies depending on each province. Total 19 at general level serious risk of hospital closure (private)We focus most of it on this Castilla-La Mancha, Extremadura and Castilla y León.
public collapse
But and What happens in public health? What if mutualism disappears? The ICC President’s document for Sustainable and Responsible Health responds strongly to this: the system must assume that: all benefits of civil servants Currently they receive it in the private system.
An economic impact is anticipated over 1,000 million eurosCorresponding to the current difference between MUFACE premium and total health expenditures, taking into account the current number of associate members The report states that there are those who prefer private health services.
In terms of infrastructure, the public system will require 3,975 extra bedsThis would mean a 3.8% addition to existing capacity nationally. “This situation, which may seem like a moderate effect at first, may be very difficult to digest in some provinces, especially “Madrid, Seville, Valencia, Barcelona, Cádiz and Málaga, among others” is emphasized.
Regarding waiting lists in the public system, “It will increase significantly nationally.” In this sense, the document’s predictions are as follows: The waiting list for outpatient treatment will increase by 266 percent, while the waiting list for surgical consultations will increase by 266 percent. It will increase by 115 percent.
Fewer oncologists
Regarding accessibility and quality of careThe document highlights that the associate member perceived “a loss of quality in service delivery in recent years, strictly due to inadequate funding of the service”. It is stated that a decrease in the number of serving hospitals and supported medical centers can be seen. elimination of emergency services decrease in the number of specialists and centers in certain centers, especially Oncology specialization.
Increased intervention times and failure to update medical charts in authorizing some procedures have reduced the quality of care.
Other notable aspects of care are the increase in waiting times, only some of the specific resources available in certain provincesincreased response times for authorization of certain procedures and inability to update medical charts “in a timely” manner.
Insurers
Regarding the characterization of mutualists depending on the chosen company – insurance companies Asisa, Adeslas and DKV are part of the existing agreement – It was concluded that DKV was the one with the lowest average age. Highest number of beneficiaries per associate member, with higher percentage of women and active associate members Corresponds to groups A1 and A2.
AsiaRather, it is the insurance company that records a higher average age, fewer beneficiaries, and a higher proportion of retired associate members. SegurCaixa Adeslas, the company that selects the largest number of regular associate members for assistance, is in an intermediate position between Asisa and DKV. In most of the analyzed variables