More than 300,000 Spaniards are not entitled to health care, according to estimates made by the Social Security. A figure that represents an increase of almost the double compared to recent figures from the Ministry of Health for 2010, which spoke of a number of excluded between 90,000 and 180,000 people. It includes in most cases long-term unemployed who have paid off subsidies, but also citizens who have worked (and paid contributions) abroad, young people older than 26 years who have not had a chance to find employment upon graduation, or unemployed people who have a property or revenues exceeding 7,000 euro per year.
The new General Law of Public Health, approved last July by the Parliament, which is going to enter into force on January 1, 2012, will try to remedy this situation, making health care a universal right for all purposes. This change will require the state to spend over 100 million euro.
Until then, the Spaniards excluded from medical care facilities are entitled to use the free public service only in case of emergency. As for the rest, three are the available options: to demonstrate that they have no income and urge health care as poor people, use a family member with a right to medical care (like a spouse, the children or the parents) or pay the full price for the services and drugs received.
In reality it is a problem far from new. Medical care is inextricably linked to the payment of contributions for 25 years, even if it is managed by the Autonomous Communities. The debate to correct this aspect of the legislation is open from 1990 (the year in which it was decided to extend the right to health care to the indigents), but the record levels achieved by the unemployment rate in the third quarter of this year (21.52 % of the population) and the consequent increase of citizens without medical coverage have made the solution more urgent than ever.
The National Social Security Institute has offered to self-governments an agreement to make the access to its database easier and to speed up the bureaucracy to provide assistance to people currently excluded from health care. For the moment, no community has responded to the call, as sources by the Institute are indicating.
Despite the changes introduced by the new law, there is another category of exclusion, who will have to wait until June 2012 to use free health care. These are the workers who belong to professional associations (such as architects, engineers and lawyers) not contained in the special autonomous regime. The debate is still open for them and it has not been decided so far whether they will ever be entitled to a completely free assistance.
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