British Expats and the (Not for Free) Spanish Healthcare System

There are two interesting articles in the Telegraph today (19th Jan.) by Peter Pallot in relation to different attitudes of British Expats in Spain to the healthcare system in Spain.

The first is entitled Spanish doctors fight expat 'freeloaders' in which he makes reference to the fact that Spanish doctors have thrown their weight behind politicians who criticise "health tourism". He makes the point that their criticism is not directed at those who register their residency status and pay taxes, but at expats in the black economy who expect to get treatment by producing a European Health Insurance Card (Ehic), which is designed for the emergency care of holidaymakers. Some of the many thousands of Britons who regularly flip between homes in Britain and Iberia are also thought to arrange trips according to where they may get the best treatment, or jump waiting lists. Politicians have been concerned about healthcare "freeloaders" for several years, but Spanish doctors have been more muted.

The second article is 'You can't go wrong if you pay your care tax' in which Peter Pallot highlights the experience of David and Gloria Newstead, both 64, who on moving to the Canaries (Spain) four years ago immediately registered with the local authority. They pay a joint sum of €264 (£234) a month for healthcare provision on the same basis as indigenous Canarians. The tax is similar to National Insurance, and also covers unemployment and some other benefits.

Having had need to use the Spanish Health Service for his wife Gloria, Mr Newstead made the comments "If you pay your tax, you can't go wrong," and "most Britons are very pleased with the health system, and he did not find the inevitable bureaucracy burdensome.

In respect of the British Expat residents of the Valencia region who are experiencing health care provision problems, refered to in the first article, and looking to, and joining, the PUMA 22 organization to try to get the Valencian Regional Government to reverse its decision to withdraw free healthcare for all, perhaps if they had taken the action similar to the Newsteads, they wouldn't have found themselves in the situation they are now.

The alternative was to have taken out private health insurance to cover the period until an entitlement exists for free healthcare in Spain under the reciprocal agreement for those receiving a state pension. I can hear the cries of 'we couldn't get full private health cover because of pre-existing illnesses'. Well in that case perhaps they could have made voluntary contributions into the Spanish system instead of relying on the special offer of free healthcare from the Valencian Government.

An offer which many of those affected by the recent withdrawal of it claim was a very major, or even the deciding, reason they decided to moved to Spain. This I believe needs to be treated with some scepticism.

Like all free offers there is always an end date due to financial costs. What was intended as an offer of free healthcare to a limited number of 'early retirees' to cover the period between the expiry of an E106 to the commencement of receipt of a state pension and entitlement through an E121, at a manageable cost level to the government, became an un-controllable expense due to the many freeloading 'non-early retirees' taking advantage of the system.

Under the current economic situation the Valencian government was bound to review the costs of the offer which had spiralled out of control. The greedy many have spoilt it for the needy few. Undoubtably the retraction of the free healthcare and the introduction of the alternative option could have been handled better. Despite the campaign by the members and supporters of PUMA 22 it is highly doubtful that the government in Valencia will return to the status quo position.

Mr Pallot makes the point that:

"The Spanish regions – which are autonomous in matters of health provision – have moved to prevent foreign nationals exploiting "free" healthcare.

The last to take this step was Valencia. Two months ago, it introduced measures by which expatriates below retirement age and not registered as employed would no longer get free access."