The Government proposes forcing Muface officials to choose between public or private healthcare without the option to change and the insurers reject it: “We cannot sign lifelong contracts”

Civil servants who enjoy Muface health and care coverage have the option, every January, to choose between public and private health care. And the truth is that more and more users are choosing the first option. It is enough to look at the history of Muface’s own records: although more than 70% still opt for private insurance, The percentage of beneficiaries of the public health system has not stopped growing in the last decade since in 2013 they did not reach 20% and at the moment they are already close to 30%.

Aware of this trend, the Ministry of Public Administration is thinking about carrying out significant changes in the model. Within the framework of the design of the specifications of the new contract, with which the Government intends to launch an express tender that is attractive for insurers and prevents the agreement from being definitively deserted, the Ministry has proposed eliminating the option of choosing between public health and the private one at the beginning of each year, as confirmed to THE WORLD sources of this department.

The Government thus seeks to be able to plan costs more accurately and better calculate the financial needs of insurers. “It is time to open a reflection on the mutualism model,” explain public service sources who add that, “in this reflection the voluntariness of the model could be addressed, which would mean that public employees now covered by mutualism can choose to be in the common regime or the special one, once and for all”.

The Ministry considers that “with this new scenario it would be easier to plan the system’s sources of income and its sustainability.” However, that “once and for all” bothers insurance companies. “They don’t see it as logical because you can’t sign a lifetime contract with them”indicate sources familiar with the impressions that are being exchanged these days between the Government and the private health sector.

However, the Ministry clarifies that “to support this reflection process, it will be important to know the conclusions of the next AIReF report.” The Tax Authority is preparing a study on the technical and economic efficiency of the model. The problem is that this document will not be made public until the end of the year, so it could be late for the incorporation of its conclusions in the calculations of the new specifications, as it was already late for the first contract, whose bidding was void last year. November 5.

From the department headed by Óscar López they assure that “the beneficiaries of Muface have the insured health care until January 31so there is enough time to launch the second tender.” In any case, they insist that “there are mechanisms in the Public Sector Contracts Law that guarantee assistance under the same conditions until the expired contract is replaced by another “

Although without expressly citing it, with these “mechanisms in the Public Sector Contracts Law”, the Ministry refers to the possibility of activating a forced extension that forces the companies that currently provide health services (Adeslas, Asisa and DKV ) to remain bound to the agreement for a period of nine months from the end of the current one. It is not plan A, which is still the launch of a new express tender that convinces insurers, but it is an option that Muface reserves in case no company attends the second concert.

“Seeing, on the one hand, that the new mutualists are increasingly leaning towards the public, as well as the fact that with a historic premium increase (17.12%) the insurers have not wanted to present offers, leaving the bidding deserted , it is time to open a reflection on the mutualism model that is based on three principles: transparency, equity and sustainability”, they conclude from the Ministry of Public Function, which speeds up the deadlines to renew the contract and prevent Muface from falling sooner. at the end of year.