The OMC and the College of Physicians of Madrid organize the IV National Congress of Private Health Practice in which they will analyze “the main threats and opportunities faced by physicians”
They address issues such as “outdated scales”, those paid by insurers to doctors; their relationship with the companies or the bankruptcy of the MUFACE model
Is it the Private sanity a profitable business? Hospital groups, insurance companies, practicing doctors or politicians meet this friday in Madrid to answer that and other questions that concern you. The sector, they say from within, has experienced constant growth. But, on the table, there are several concerns: the bankruptcy of the MUFACE model, the low rates that insurers pay doctorswaiting lists, policies low cost… Issues that, they point out, are harming them. “We have a problem and we want to find solutions“he admits to The Spanish Newspaperfrom the Prensa Ibérica group, the national representative of private practice professionals of the Collegiate Medical Organization (OMC), José Luis Alcibar.
The OMC is, together with the Official College of Physicians of Madrid (ICOMEM), the promoter of the IV National Congress of Private Health Practice, a day in which, as its call states, different voices will analyze “the main threats and opportunities that physicians face.” The program talks about addressing issues such as “outdated scales”, those paid by insurers, which make it “unsustainable” medical practice in the private sphere; the shortage of specialiststhe professional relationship of doctors with insurance companies or the bankruptcy of the MUFACE model.
On the occasion of a meeting for which there is great expectation, José Luis Alcibar reflects for this newspaper on those issues that worry a sector that has been in turmoil for months and where, on the other hand, boast, thanks to the development of new health infrastructure, to the birth and increase in the number of insurance companies dedicated to health or investment in medical technologyamong other factors, economically at least, is experiencing boom times.
A conflict situation
“Right now we live in a situation of conflictderived from the healthcare pressure that has increased in recent times, more as a result of the pandemic, and some discrepancies regarding the fee received by the doctor and what What do you think you should perceive?. There is a very great degree of dissatisfaction among professionals: the cost of living in the last 20 years has increased with the CPI and the costs of managing their liberal activity have been rising and salaries have not”, Dr. Alcibar explains.
A doctor in a hospital.
| EPE
It refers to how the market has been adjusting for those doctors that, in a very high percentage, they act as self-employed and, in 70% of cases, he estimates, they still do not receive an increase in their fees. “Before you had a group of patients that were private, privatewho paid out of pocket and, with the aggressive policies of the insurance companies, attracting all patients who were dependent on using private medicine and other types of strategies. like low cost policies, etc., the cost of the activity has grown a lot and the income has not,” he complains.
And his colleagues, he summarizes, are realizing that “It is no longer worth it for them to continue with this activity”. The market “has adjusted itself and we have reached the situation we are in now,” adds the college representative.
Patients decide
The doctor will attend the meeting in Madrid Ignacio Guerrero, president of the Professional Medical Union (UNIPROMEL), which represents a large part of freely practicing doctors. Just a few days ago, the doctor explained to The Spanish Newspaper that some 250,000 professionals – not just doctors – work in the sector as self-employed. He announced that he will lead the Professional Union of Self-Employed Private Health Workers to be able to start a collective bargaining against the insurance companies and achieve an agreement that regulates the labor relations of those professionals who collaborate in hospitals, polyclinics or private centers.
“If there is no price agreement, doctors will bill their services freely, giving a copy (to the patient) so that they are informed of how much their policy covers,” says Dr. Guerrero.
“We will be in Madrid and it will be explained how the situation in the sector will be from January 2024. If finally insurance companies They do not accept collective bargaining and persist in the abuse of a dominant position by imposing their scales. If there is no price agreement, doctors will bill their services freely to the companies and provide a copy (to the patient). so you are informed of how much your policy covers you and what is the price of the doctor. Maybe they have to claim the difference as reimbursement of expenses or making co-payments”details.
Look for solutions
Dr. Alcibar elaborates: without the intention of looking for culpritsthe Congress of private healthcare looks for exits to the different open fronts: “As we live in this reality and have a problem, we want to look for solutions.” Because, he says, reality is what it is. For example, for the first time, There are waiting lists for private consultations and that makes patients complain: “That only happened in the public sector and now it is also seen in this sector”.
Dr. Alcibar recreates a situation that, he assures, is being recorded in these consultations: patients who call to make an appointment with a specialist saying they are from an insurance company and they give it to you within a month and, when it is a purely private patient – who pays directly for the consultation -, they give you an appointment for the next day.
“I think that is something that patients also complain about, because they are vulnerable to this situation. I don’t know if it is a good practice, I do not practice it nor do I recommend that it be done, but there are those who complain about this situation The reasons that have led some professionals to do this is to establish preferential treatment in those activities that are most profitable“, he assures.
The MUFACE model
The school representative also talks about the MUFACE issue: “I, as a national member, listen to the members of many schools. There are big cities -like Madrid, Seville, Malaga, Barcelona…quote- where people who take out private insurance or they are groups of companies or private patients who decide to have this coverage to expedite care“.
There are smaller cities “where dependence on the public insured is very important for private doctors and it is true that the financing of that system is deficient,” says Dr. Alcibar.
But, he continues, there are smaller cities “where dependency of the insured official It is very important for private doctors and it is true that the financing of this system is deficient. It has to be given a spin. It is no longer that the doctor earns little money with this activityis that insurers are also saying that with The money that is budgeted does not reach everything that is demanded from the group. Yes, it is a system that is bankrupt and it would take quite a toll on some doctors because, in those areas where there is not so much availability of professionals, certain consultations may be compromised.”
Concentration of officials before MUFACE.
| EPE
Another aspect that will be addressed at the national meeting of private medicine is the supposed lack of doctors. There, Dr. José Luis Alcibar, dissents. “I’m going to be controversial, but it’s a myth. In reality, we are one of the first countries in the European Union with the most professionals per 100,000 inhabitants and we have a system of training doctors at the university and specialists, what is the jewel in the crown. There is no shortage of professionals. What is missing is that these professionals are motivated to do their work. One of the problems in the health Spanish, both in the public as in the private, which are communicating vessels, is underfinancing“he concludes.
The law of equity
From the employers’ association of private hospitals, on Thursday they expressed another concern that, in this case, concerns the political sphere and does not go through the internal problems that afflict the sector. The Spanish Private Health Alliance (ASPE) showed “the confusion generated and the enormous concern in the sector in response to the health proposals included in the announcement of the agreement PSOE-Sumar coalition government in case of investiture of the candidate Pedro Sanchez“.
A nurse administers a vaccine.
| Archive
The measures included in the aforementioned agreement, they point out, “will have a high health cost for the citizen, fundamentally in three axes: approval of the Equity Law and its “direct consequence in the absence public-private collaboration“; also derived from the above, “the practical infeasibility” of carrying out the announcement to “end waiting lists with a law of maximum times”; and, finally, they add, the reduction of the working day at 37.5 hours “and how it would impact the need to increase staff in healthcare companies.”
This situation, they conclude, would occur when there is “a serious deficit of health professionals, both in medicine and nursing. The situation has no signs of improvement without urgent measures that allow mitigating the problem in the short term. so this labor legislation would cause enormous adversity“, ASPE ditch.