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Total health expenditure (public and private) in relation to Spain's GDP (10.7%) is below the OECD average (10.8%), while the weight of private health expenditure in relation to the total (2.9%) is among the highest, together with Portugal (3.7%) and Switzerland (3.6%), while the OECD average is 2.3%. In addition, if public spending on private health via concerts is added to this figure, the percentage amounts to 3.64% of GDP, 40,727 million euros. These concerts account for 10.2% of total health expenditure and, of these, approximately half is allocated to medical transport.

These are some of the data that emerge from the report Private Health, Adding Value 2023, prepared annually by the Institute for the Development and Integration of Health (IDIS Foundation) and presented last Thursday in Madrid.

The report highlights not only the important presence of private health in the Spanish system, but its continuous growth: "The volume of insured has increased in all provinces, largely due to the very serious problem of access to public health," said Marta Villanueva, general director of the IDIS Foundation and in charge of presenting the report.

It shows how the volume of users of private health has not stopped growing in the last five years, almost 4%, reaching 12 million people between insured and mutual society members. With all this, according to Villanueva, "the savings that private health represents to the public system goes from 6,185 million euros, if all the insured use both systems, to 17,283 million if they make exclusive use of private health".

Rental co-pays

The president of IDIS, Juan Abarca, commented that, in light of these data, "a change of model is necessary that serves to redirect the drift" in which the health system finds itself.

From left to right: Juan Abarca, Marta Villanueva and Ángel de Benito, president, general director and general secretary of the IDIS Foundation, respectively. Nina Prodanova

Among the proposed measures, Abarca spoke of reducing the costs of the system, adjusting coverage and introducing "co-payments by income level", something he considers essential. He also defended the increase in health spending between 1 and 2% of GDP to place Spain at the same level as the rest of European countries.

For the president of the IDIS Foundation there are two main problems of the system that are the lack of sociodemographic adaptation of the population and the "abandonment of the elderly patient", all this together with a "lack of acceptance of public-private collaboration".

However, he considers, with an eye on the next elections, that "none of the main political parties is predisposed to face a real reform that responds to the health needs of the population."

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