At a time when it is both criticism and discourse about health and business, scandalously visualizing the statements of the CEO of Ribera Salut, Pablo Gallart, at the Torrejón de Ardoz Hospital, I cannot help but think of Ernest Lluch, Minister of Health between 1982 and 1986, member of the General Health Law and the current Spanish health system, in addition to Valencia and its adoption for many years. Here we have the symbol of two models. The first place, that of the private health system, is thought and structured as Pablo Gallart explains, and according to that of the public health system that Ernest Lluch will establish, it is almost quanta anys and that, despite all the serious deficiencies, gaudim all Spanish citizens.
Yes, we can wrongly say that we have a good Spanish public health system if we compare it to the private health system which is, for example, the most advanced country in the world, the United States. Americans spend more than double their GDP on health care than the Spanish, but the results are clearly pitiful: we see all the mitjana households that elude us, they tend to die at a higher rate than in Spain from treatable illnesses, and they have pitiful health indices. It is obvious that on a personal and family level, they run the risk of very significant ruin due to health fears. In the United States, 66% of bankruptcies are due to medical reasons affecting four adults in this country one day.
The health panorama of this country does not exactly invite the privatization of the Spanish health system. Because the PP promoted the Alzira Hospital model, it was secretly based on the paradigm of public-private collaboration to break the administrative rigidity that prevented immediate modernization of health care and reduction of costs. The reality has been very different from that of its drivers: it is regrettable that the per capita fee of the Generalitat increases from 225 euros in 2002 to 777 euros in 2017, the Alzira Hospital concession has been in financial ruin for a few years, which will ultimately result in additional payments of 25.11 million euros. On the other hand, the advantages of this reduced model serving the population are not twenty per inhabitant.
On the other hand, many of Ribera Salut’s behaviors closely resemble those of the large North American health oligopolies: the purchase of health equipment, biological analyses, clinical diagnosis or hospital services go through any subsidiary of the company. In the United States, as things have happened more quickly, they have come more slowly in the process of concentration: just three companies control 80% of medical prescriptions, with the health care market dominated by a series of economic giants who control the regulatory system by tilting it in favor of a group called health companies.
Crida attention to a system so unjust and ineffective that it persists in a democratic system, governs who governs. The answer lies in the political influence exercised by these companies which, with the pharmaceutical industry, are those which devote the most resources to these needs (380 million euros for the latter). North American political leaders cannot afford not to pamper the interests of the corporations that finance their various meetings and election advertisements. In short, it is health companies that control public authorities. Not the opposite as it should be.
In the Valencian Country, the process of return to the public health system of the Alzira Hospital and subsequently those of Torrevieja and Dénia will assume the existence of claims named both judicially and administratively on the part of the contracting companies: vint-i-sis in La Ribera, vint in Torrevieja and dèneu in Dénia. But the problem does not only lie in the judicial viacrucis to which Ribera Salut is subject to the Generalitat Valenciana. It is certain that Mónica Oltra would not undergo the legal ordeal to which she is subjected if she did not demonstrate a determined and courageous attitude, alongside Carmen Montón, in the process of handing over the Ribera Hospital to public health. See, on the other hand, the companies of Mr. González Amador, alongside Ms. Ayuso, both directors of the Quirón company – the equivalent of Ribera Salut in Madrid – and of the “successful” brand, but in a certain way, way of working for justice and politics, it seems that the relations between the health sector and the political world of the Madrid capital are increasingly integrated into the system that dominates the United States.
Joan Riboformer mayor of Valencia
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