Generalizar la tasa del euro por receta aportaría casi mil millones
Los posibles ingresos serían el 1,7% del presupuesto sanitario
Mejorar la eficiencia en las compras y los tratamientos aportaría el mayor ahorro
スペインの医療費の赤字の76億0000'0000ユーロ(7600億0000'0000円)の解消のために、薬の処方箋1枚につき1ユーロ(100円)を徴収すると、9億7300万0000ユーロ(973億0000'0000円)の収入、赤字の4%
Generalizing the prescription rate of the euro would provide nearly a billion
Any revenue would be 1.7% of health budget
Improving efficiency in procurement and treatments would provide the greatest savings
Emilio de Benito Madrid 30 MAR 2012 - 00:01 CET
Any revenue would be 1.7% of health budget
Improving efficiency in procurement and treatments would provide the greatest savings
Emilio de Benito Madrid 30 MAR 2012 - 00:01 CET
The approval of a fee of one euro per prescription in Catalonia by the Executive with the abstention necessary CiU PP's open season. Despite the protests against the Minister of Health, Ana Mato, and the prime minister, Mariano Rajoy, other communities look with envy as Catalan. And most seem to not dare to pass something on their own, but that would not look askance at a joint initiative in this regard. A proposal that could begin to brew in the Budget presented today, or at the latest at the next Council Interterritorial National Health System, which is not yet convened.
The debate is recurrent. But lack perspective: how much money we talking about? Public expenditure on health is, in large numbers, at 65,000 million euros a year. But the budgets of communities, which are responsible for providing the service in 2011 totaled 57,400 million, according to the Ministry of Health. And therein lies the cause of the deficit, about 7,600 million annually. This lack of funds has to reflect the growing debt with suppliers, which is around 16,000 million and if you add up the labs, suppliers of medical technology, pharmacy and others (management, security, cleaning ... etc).
On the other hand, the number of prescriptions was public, in 2011, of 973 million. So if you charged a euro for all, as much would be raised 973 million (1.7% of total budget). But that would be if there were any exceptions. If implemented which already exists with the current system of co-payment (retirees do not pay, considering that the average amount of pensions in Spain is 800 euros per month), the figure would have a significant reduction. Because according to the latest data the ministry, 71.13% of the recipes are in the name of this population. In that case these theoretical 973 million would remain, at best, in 280 million. And it remains an estimate upward as it does not include chronic-candidates also to be excluded, or exceptions as the non-collect from the counter 62, as established Catalonia. Those 280 million represent 0.49% of the budget, or 4% of the deficit.
more informationHealth copaymentA torpedo in the water line of the national health systemRecipes repaymentThe health copayment
These are only speculations. In fact, Catalonia has been more rigorous, and included fewer exceptions. Only those who receive income from insertion (less than 500 euros a month because they have not quoted) are exempted from payment.
On the other hand, there are some factors that reduce even further the amount entered by charging per prescription. Because what would be normal for the number of these come down somewhat.
And there is another factor, which is not included, which is the risk of increased costs. These begin with the management of the process (that Catalonia has solved cargándoselo to the pharmacy). We should also quantify the risk of a patient, not taking medication and save the euro for the recipes, develop a much more serious, as denounced medical organizations (starting with the WTO) and the parliamentary spokesmen UI , Gaspar Llamazares, and PSOE, José Martínez Olmos, in Congress, among others. For example, it may happen that you stop taking an antihypertensive and it ends with a stroke. And a single case can cost thousands of dollars on treatments. A study by the University of Navarra figure the less severe (and cheaper) for stroke in more than 67,000 euros. This figure would be, for example, all that may be charged to enter a euro Galicia prescription throughout the year, according to data just released by Health.
Communities expect you to take a joint decision
The recipes is the first of the areas in which states with copayment. There are other proposals that apply in other countries, such as charging per day of hospitalization, or emergency consultation. But in this case, the figures are much lower than the recipes. For example, each year about 5.3 million hospital admissions, generating 42.3 million days of hospitalization. One option that has considered is to charge for the so-called hotel services (laundry, meals). But that has at least three objections. The first is economic. A one euro, the amount raised would be even lower than that achieved by taxing the recipes. The second, which in this case there is no deterrent effect on the patient, because the entry is determined by a physician, as indicated by the IU spokesman, Gaspar Llamazares, when the matter was debated in Congress. And, third, that any of these aspects, such as food or hygiene should be considered part of treatment, and failure to do so would risk conveniently, again, outweigh the benefits in the form of malnutrition or infections.
It has also been elucubrado once with charge for emergency room visits. At year about 27 million. Of these, approximately three million end in hospital, which is a good indicator that visits are necessary (and, therefore, hardly punishable). Even so, 74% of them were unnecessary, according to the Health Barometer 2009. This yields about 20 million actuations that would be taxable. Of course the cost of this proceeding is or may be-very small, just a good selection (triage in the technical language) prior to these persons are not served and are sent to primary, which not only generate spending that service, as indicated by the Society of Emergency Medicine.
Finally, there is the possibility of receiving queries: 82 million performances a year, according to Health. In some countries like Germany or Italy, it takes up to 10 euros, which would yield 820 million. Again, apart from issues such as the patient is punished and that exceptions should be established, the risk that has not prevented a more serious pathology, which would defeat the savings.
Catalonia pharmacies assume makes the process cost
This does not mean that the deficit is somewhat intractable. To begin with, is caused because no budget is necessary, and that is a matter of public accounts to develop realistic, as noted by the Federation of Associations for Public Health Advocacy.
The ability to increase revenues have other options. For years the option of taxing fuels. And, curiously, despite the crisis, six communities (La Rioja, the Balearic Islands, Aragon, Basque Country and Navarra) have not yet done. In the same vein, the PSOE and defended during the last election campaign and then led him to Congress a finalist tax increase on alcohol and snuff.
The other possibility, of course, is to reduce expenses. The clearest example of this can be achieved is the drug. The successive steps of the previous government have made the game what he does to pay the pharmacy to decrease from last year and half. From the moment of maximum expense (12,698,000 in the 12 months July 2009 to June 2010) to the last data (10,999,000 between March 2011 and February 2012) indicate that savings can be achieved.
The option to upgrade brings greater efficiency savings
This line is also the savings can be achieved with centralized purchasing. The first attempt succeeded in lowering the bill for 3.2 million flu shots, and the figure will increase as more communities join and spread far more supplies, which the present Government has offered.
Also in this regard is the proposal to auction Andalusia down the supply of medicines to pharmacies. Only in the community and for the 16 groups of drugs was estimated a savings of 41 million. The Socialist Party said in a statement that defended-and lost-in Congress that extending and expanding throughout Spain could reach 1,500 million.
And finally there is the review of benefits, to fund only those who truly serve. There is no estimate of the savings capacity of this measure, but there are some hints. Kovacs Foundation, an expert on back pain, estimated at around 75 million it spent on useless treatments about alone in this field. The FADSP goes further, and estimated that only by avoiding the use of unnecessary medications could save 1,300 million a year. They would add 950 million for an appropriate use of health technologies. The decrease unnecessary hospitalization would provide 5,750 million and a 10% reduction in emergency room visits would be another 650 million. If you add only indicating the federation, would be 2,250 million in misused drugs and technologies (if all annual health deficit) and other 6,400 million (over 10% of expenditure) in use of resources.
The occasion could be the future law of common services portfolio announced Health Minister Ana Mato. This is no lack tools: the state agency and the six regional assessment, which will be networked. Of course you should go for that review process to process, and that takes time and money.
The debate is recurrent. But lack perspective: how much money we talking about? Public expenditure on health is, in large numbers, at 65,000 million euros a year. But the budgets of communities, which are responsible for providing the service in 2011 totaled 57,400 million, according to the Ministry of Health. And therein lies the cause of the deficit, about 7,600 million annually. This lack of funds has to reflect the growing debt with suppliers, which is around 16,000 million and if you add up the labs, suppliers of medical technology, pharmacy and others (management, security, cleaning ... etc).
On the other hand, the number of prescriptions was public, in 2011, of 973 million. So if you charged a euro for all, as much would be raised 973 million (1.7% of total budget). But that would be if there were any exceptions. If implemented which already exists with the current system of co-payment (retirees do not pay, considering that the average amount of pensions in Spain is 800 euros per month), the figure would have a significant reduction. Because according to the latest data the ministry, 71.13% of the recipes are in the name of this population. In that case these theoretical 973 million would remain, at best, in 280 million. And it remains an estimate upward as it does not include chronic-candidates also to be excluded, or exceptions as the non-collect from the counter 62, as established Catalonia. Those 280 million represent 0.49% of the budget, or 4% of the deficit.
more informationHealth copaymentA torpedo in the water line of the national health systemRecipes repaymentThe health copayment
These are only speculations. In fact, Catalonia has been more rigorous, and included fewer exceptions. Only those who receive income from insertion (less than 500 euros a month because they have not quoted) are exempted from payment.
On the other hand, there are some factors that reduce even further the amount entered by charging per prescription. Because what would be normal for the number of these come down somewhat.
And there is another factor, which is not included, which is the risk of increased costs. These begin with the management of the process (that Catalonia has solved cargándoselo to the pharmacy). We should also quantify the risk of a patient, not taking medication and save the euro for the recipes, develop a much more serious, as denounced medical organizations (starting with the WTO) and the parliamentary spokesmen UI , Gaspar Llamazares, and PSOE, José Martínez Olmos, in Congress, among others. For example, it may happen that you stop taking an antihypertensive and it ends with a stroke. And a single case can cost thousands of dollars on treatments. A study by the University of Navarra figure the less severe (and cheaper) for stroke in more than 67,000 euros. This figure would be, for example, all that may be charged to enter a euro Galicia prescription throughout the year, according to data just released by Health.
Communities expect you to take a joint decision
The recipes is the first of the areas in which states with copayment. There are other proposals that apply in other countries, such as charging per day of hospitalization, or emergency consultation. But in this case, the figures are much lower than the recipes. For example, each year about 5.3 million hospital admissions, generating 42.3 million days of hospitalization. One option that has considered is to charge for the so-called hotel services (laundry, meals). But that has at least three objections. The first is economic. A one euro, the amount raised would be even lower than that achieved by taxing the recipes. The second, which in this case there is no deterrent effect on the patient, because the entry is determined by a physician, as indicated by the IU spokesman, Gaspar Llamazares, when the matter was debated in Congress. And, third, that any of these aspects, such as food or hygiene should be considered part of treatment, and failure to do so would risk conveniently, again, outweigh the benefits in the form of malnutrition or infections.
It has also been elucubrado once with charge for emergency room visits. At year about 27 million. Of these, approximately three million end in hospital, which is a good indicator that visits are necessary (and, therefore, hardly punishable). Even so, 74% of them were unnecessary, according to the Health Barometer 2009. This yields about 20 million actuations that would be taxable. Of course the cost of this proceeding is or may be-very small, just a good selection (triage in the technical language) prior to these persons are not served and are sent to primary, which not only generate spending that service, as indicated by the Society of Emergency Medicine.
Finally, there is the possibility of receiving queries: 82 million performances a year, according to Health. In some countries like Germany or Italy, it takes up to 10 euros, which would yield 820 million. Again, apart from issues such as the patient is punished and that exceptions should be established, the risk that has not prevented a more serious pathology, which would defeat the savings.
Catalonia pharmacies assume makes the process cost
This does not mean that the deficit is somewhat intractable. To begin with, is caused because no budget is necessary, and that is a matter of public accounts to develop realistic, as noted by the Federation of Associations for Public Health Advocacy.
The ability to increase revenues have other options. For years the option of taxing fuels. And, curiously, despite the crisis, six communities (La Rioja, the Balearic Islands, Aragon, Basque Country and Navarra) have not yet done. In the same vein, the PSOE and defended during the last election campaign and then led him to Congress a finalist tax increase on alcohol and snuff.
The other possibility, of course, is to reduce expenses. The clearest example of this can be achieved is the drug. The successive steps of the previous government have made the game what he does to pay the pharmacy to decrease from last year and half. From the moment of maximum expense (12,698,000 in the 12 months July 2009 to June 2010) to the last data (10,999,000 between March 2011 and February 2012) indicate that savings can be achieved.
The option to upgrade brings greater efficiency savings
This line is also the savings can be achieved with centralized purchasing. The first attempt succeeded in lowering the bill for 3.2 million flu shots, and the figure will increase as more communities join and spread far more supplies, which the present Government has offered.
Also in this regard is the proposal to auction Andalusia down the supply of medicines to pharmacies. Only in the community and for the 16 groups of drugs was estimated a savings of 41 million. The Socialist Party said in a statement that defended-and lost-in Congress that extending and expanding throughout Spain could reach 1,500 million.
And finally there is the review of benefits, to fund only those who truly serve. There is no estimate of the savings capacity of this measure, but there are some hints. Kovacs Foundation, an expert on back pain, estimated at around 75 million it spent on useless treatments about alone in this field. The FADSP goes further, and estimated that only by avoiding the use of unnecessary medications could save 1,300 million a year. They would add 950 million for an appropriate use of health technologies. The decrease unnecessary hospitalization would provide 5,750 million and a 10% reduction in emergency room visits would be another 650 million. If you add only indicating the federation, would be 2,250 million in misused drugs and technologies (if all annual health deficit) and other 6,400 million (over 10% of expenditure) in use of resources.
The occasion could be the future law of common services portfolio announced Health Minister Ana Mato. This is no lack tools: the state agency and the six regional assessment, which will be networked. Of course you should go for that review process to process, and that takes time and money.
スペインの医療費の赤字の76億0000'0000ユーロ(7600億0000'0000円)の解消のために、薬の処方箋1枚につき1ユーロ(100円)を徴収すると、9億7300万0000ユーロ(973億0000'0000円)の収入、赤字の4%
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