Monday, 23 April 2012

Anti-crisis measures 1: The end of free medicine

First in a series about new government anti-crisis measures
SPAIN This is the end of free medication for pensioners in Spain, among other measures to be taken to reduce the cost of the national health care budget. The new system announced recently and approved at last week's Cabinet Meeting, links income to payment for medicines. Perhaps the most difficult part of the new measure is the creation of a single, nation-wide card that will be linked to the Tax Office, which will allow what level of payment each pensioner belongs. This is complicated in a country that even after 10 years of regional health authorities, has yet been unable to make any kind of online connection among them. At the announcement, prior to the Cabinet meeting, Health Minister Ana Mato said that the measure is more 'educational' aimed at people getting to know the real cost of their medications. It is expected that these measure will take about two months to be put into effect, though the actual process will probably take longer to 'trickle down'while technical and administrative problems are sorted out. So how does all this actually affect everyone? PLEASE BE AWARE THAT ITEMS SUCH AS THIS MAY BE SUBJECT TO SUBSCRIPTION IN THE FUTURE but you can make a donation NOW, too! Please click here for more information on how to help us continue.>>>
Until now anyone receiving a pension (with only a few exceptions) got free medications when they were prescribed by a doctor. From now on (or when the system actually comes into play) the average cost will be about 10% of the actual cost. The only exceptions to this rule of thumb are pensioners receiving the minimum non-contributive pension, and the long-term unemployed.

There will be three groups of co-payers, depending on their income: 1. those who are exempt from making a tax return (due to low income, established as below €22,000 per year) who will pay a maximum of €8 per month; 2.Those with an income up to €100,000 will pay the same 10% but up to a monthly maximum of €18; and an income above that, it's 20% up to €60 per month.

People in work will also have to pay a portion of the cost of their medicines: 40% if under the non-declarable maximum, and up to 50% thereafter. And again, an income above the €100,000 mark means paying up to 60% of the cost.

Other adjustments to the system, which will take a while to implement, include getting manufacturers to make what are known as unidoses: for instance, if treatment means taking a particular pill three times a day for a week, they will package it in boxes of 21, and so on. This is difficult but makes economic sense, as many medicines come in large quantities and are thus wasted, which is expensive.

Another measure being studied is a central buying system. An experiment was carried out in 2011 with the flu vaccine; it was successful and several autonomic regions will be pooling their purchases of next season's vaccines.

Nevertheless, the major savings -as distinct from cutbacks- will come from the usual place: medicine purchases. Several regions, including Andalucía, have already established that prescriptions are made for the active ingredient of a medication as opposed to a brand. This also means that generics will be supplied whenever possible.

A culling of medications on the long list from which purchases are made is also probable, although the Health Ministry is at pains to point out that medicines will not be excluded exclusively on price.
Other measures sound old: the single electronic health card to be used nationwide, digital medical history ... The ideas are good but expensive to set up and the savings are not yet clear.

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