BarcelonaIn the more than forty years in which Montse Pujadas worked as an employee at the Tax Agency in Barcelona, she had only used the private mutual benefit she enjoyed as a public employee for some occasional tests and reviews. The moment when he most needed this healthcare did not come until two years ago, when he was diagnosed with colon cancer, which is now stage 4 and has metastasized. The critical point of his illness coincides with the beginning of the conflict between the Spanish government and the insurers that guarantee the service of Muface, the mutual that gives cover to 1.5 million people between civil servants and their beneficiary relatives.
This week the council of ministers put their offer on the table, with a record increase of 17% compared to the premium of the previous competition. The proposal, however, was far from the aspirations of a 40% increase wanted by the companies that are threatening to leave the call empty because they consider that the economic conditions are insufficient. At this point, Pujadas still cannot know whether in 2025 he will have the health care that has accompanied him so far in the treatment of the cancer he is suffering from.
“The civil servants of my time could choose between Social Security or a mutual one and most of us took the private one because when we entered we were younger, we didn’t have illnesses and if you had to get tested it was faster,” explains this public worker in the NOW In his case, he chose DKV health coverage and is currently undergoing chemotherapy treatment in a hospital in Barcelona included in this insurance. His main fear is that the parties will not reach an agreement and that at the beginning of 2025 – when the current contract ends – he will find that he has to start the whole process again along the path of public health: “If there is not a OK, I can’t stop the chemo. They can’t be putting money before people.”
“In my time we could choose between Social Security or a mutual, and most of us took the private one,” says Montse
Pujadas points out the psychological stress that this situation is causing him, at a time when he only asks for “emotional stability” and “tranquility” to face a very difficult stage of the disease. “If I go on Social Security and something happens to me, I hold the government accountable,” he says. Nor does he consider continuing with the same private insurance company on his own, because the cost of the tests would be too high, or hiring a new one, because there is already a pre-existing disease. “I personally could not feel more distressed,” she laments. It must be remembered that this system is financed through the contributions of public employees (around 20%) in each payroll, while practically 80% of the remaining resources are provided by the State.
This former employee of the Tax Agency understands that for insurers, Muface’s is surely a “loss-making” business, but she also remembers that hers is an increasingly advanced age group and asks that they not apply drastic decisions . In fact, it ensures that the public employees who now enter the body of the administration opt mostly for Social Security. “I understand it’s a privilege and I agree that maybe from the beginning we should have gone public, but now it’s done and it’s not our fault. We were given the option and we took it take, now they can’t take it away from us,” he complains.
Shift towards public health
Between 2010 and 2023, the number of Muface beneficiaries using Social Security in Spain has increased by 72% to 457,307 people and these already represent almost 30% of the total. Even so, according to the latest data available from the Ministry of Digital Transformation and Public Service, the coverage that provides medical assistance to more people than public health is still Adeslas, with 508,703 users. In Catalonia, on the other hand, there are already more people covered by Social Security (59,962) than the most popular insurance company of the three that offer this service, which is DKV, with 57,837.
“I don’t know if I have the strength to start again,” says this former employee of the Tax Agency
Contacted by the ARA about the situation of people like Pujadas, who are in the midst of an illness with a serious prognosis when this dispute broke out, from the ministry they limit themselves to reminding that the process is still open and the applications have just been presented financial conditions for the concert. As long as this situation is not resolved, the patient does not even want to imagine a scenario in which she has to change doctors and put herself in the hands of a new oncologist at this stage of her cancer. “I don’t know if I have the strength to start again. What awaits me at the end is hard and I want to spend it psychologically well and without having to think about anything else,” he concludes.
