Wednesday, August 4

More financing, data science and digitization for an equitable social and health system


More investment. More digitization. More innovation. And more public-private collaboration. These are the main needs faced by the Spanish health system if it wants to offer citizens a fair, quality and efficient Healthcare. The person in charge of explaining this “diagnosis” was Juan Abarca, president of the IDIS Foundation (Institute for the Development and Integration of Healthcare), who participated yesterday in the conference entitled “The health system in Spain in the post-covid-19 era” organized by INFORMATION.

In the meeting held both in person and online and with the participation and assistance of medical professionals from across the province, the president of the IDIS Foundation analyzed the impact of covid-19 on the Spanish health system and what the reforms are that it would be necessary to start taking decisively to guarantee a quality healthcare offer in a context in which the impact of many of the known problems, such as the aging of the population or the chronification of processes, have accelerated in the last year .

A year that has shown that the public health system is insufficient to cover all the needs of the population. “For years we have cheated the lonely until the pandemic has arrived, which has broken all the seams and has exposed the difficulties of our public health system to face all the health demand of the country,” emphasized the speaker.

As he pointed out, the pandemic has valued private healthcare (it has treated one in three covid-19 patients) and has become an essential resource to face a situation as exceptional as that experienced around the world. In this sense, he considered that “the private health sector is an essential part of the public health system”, for which he advocated “renewing trust between the two” to create a model based on continuity of care.

«Private health has techniques that are not in the public sector. If so, why isn’t there a pact to make healthcare resources available to all people? “Asked the president of the IDIS Foundation, while advocating for a” pact for innovation so that everyone world get access to the latest technology ». And he added: “Anything that excludes the private sector goes against the people and it is the citizens who lose.”

To guarantee a good and quality health service, Juan Abarca explained some of the reforms that need to be carried out in Spain because “otherwise we are going to go to a health system like that of Brazil, where public health has practically remained for charity” .

More investment and financing

Regarding the measures to be taken, the president of the IDIS Foundation highlighted above all that of increasing public financing and investment. «The neighboring countries invest around 9% of GDP and we are at 6.2%. By 2050, investment is expected to reach 7%. We are convinced that 6.2% is insufficient by 2024. At least two more investment points are needed, ”he pointed out. Likewise, he opted for providing a “continuity” solution to citizens “from birth to death”, while defending determining and adjusting the levels of health coverage.

At this point, he recalled that “each autonomous community has a catalog of minimums and then each one does what it wants.” Faced with this situation, he interceded to coordinate this point at the national level so that the system is truly equitable. “This does not mean that Health has to be recentralized, but it does mean that it is coordinated. Especially from the point of view of prevention. If an autonomous community decides not to invest in prevention, all Spaniards are going to pay for it in 20 years ”.

The next point that stood out when facing the future of the health system was that of governance and management models at all levels. Thus, he described that the performance of politicians in terms of “macro-management” has been a “shame” in the pandemic. Regarding the level of “meso-management”, he said that it is necessary to organize health services “based on population volumes, since health has nothing to do with that of 30 years ago.” To finish this section and in the «micromanagement», Juan Abarca considered essential to begin to enforce a minimum of results in the centers to know the operation and the success rate, or failure of the same.


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Bringing Healing to the Present

The digital transformation of the health system was also present at the meeting. In the opinion of the president of the IDIS Foundation, facing this challenge would allow a “solution of health continuity regardless of where the patient passes, placing the patient at the center of everything and avoiding inefficiencies and duplications.” To achieve this, he stated that it is essential to create a system that allows collecting clinical information, measuring and “learning to manage demand and not just supply.”

At this point, he recalled that the IDIS Foundation and its associates are already working on the creation of a platform, which they have also presented to the Government, with the aim of “not staying in the 20th century.” Within digitization, Juan Abarca also addressed the importance of data in health management. «The irruption of data science is going to change medicine and it is going to allow a more inclusive medicine. Personalized medicine will come when we know how to manage the data. We have to go towards personalized predictive medicine ”, he stressed.

Regarding the other two points that should be addressed in the post-covid-19 health system, the speaker highlighted the importance of educating the population and betting on patients. Something that, from his point of view, patient associations have to do, “who must be given collective rights,” he said. In this regard, he regretted that at present “there is a hodgepodge of associations without order and without funding” which should be ordered and “give an official voice within the institutions.” Finally, he opted for the need to invest in innovation and industry to avoid having to go to other countries to, for example, buy medicines.

Public-private collaboration

According to the perception survey on the contribution of Private Healthcare prepared by the IDIS Foundation after the pandemic, about 70% of the population considers the collaboration of private health to reduce the saturation of the public health sector important. Likewise, the survey reveals that 77.8% of the surveyed population values ​​the technological resources of private healthcare for the prevention, diagnosis and treatment of diseases as good or very good.

Juan Abarca pointed out that the savings generated by the Health insurance to the State coffers would move in a range between 4,690 and 12,600 million euros depending on whether the insured makes a mixed use of health, using both public health and private (savings of 506 euros per person per year) or if the patient exclusively uses the private system (savings of 1,368).

He also recalled the role of private health in reducing waiting lists in the public system. In 2018, private hospitals carried out 30.2% of surgeries, 23.7% of discharges and 24.4% of emergencies throughout the national territory. In addition, the private health sector has a staff of 441 hospitals in Spain.

With respect to the last year, Juan Abarca warned that “14 million fewer diagnoses have been made, 25% less, as well as 18% fewer surgical operations.” For this reason, he insisted that the pandemic has generated significant sensitivity in the population and assured that people are more aware of the importance of having the private sector so that the health system responds efficiently.

“The thing about Torrevieja makes me ashamed and afraid of others”

The decision taken by the Conselleria de Sanidad Universal y Salud Pública de la Comunidad Valenciana in 2020 not to extend the management contract of the Torrevieja Department of Health and initiate the procedures for said contract to end in October 2021 was also addressed during the meeting held yesterday. Juan Abarca regretted the decision by stating that Torrevieja’s measure “makes me ashamed and terrified.”

Above all, he pointed out, “when there is no report against the management and even the Audit Office gives favorable data.” Regarding this point, this institution reported last week that the average waiting time for an intervention at the Torrevieja University Hospital, belonging to the Ribera health group, is 42 days, ranking as the health department with the least surgical delay in the Valencian Community.

“I do not understand how patients do not come out to demonstrate because the waiting lists are going to be multiplied by three,” said the president of IDIS, while criticizing the attitude of the Department that is causing “the concessionary model to be disgraced an ideological question and creating a much worse alternative. Public administrations have the obligation to manage money well and they are throwing it away at the expense of the health of patients.

The Minister of Health Ana Barceló pointed out last Thursday that the management of the Torrevieja Health Department will pass directly into the hands of the Ministry and will not be carried out through a public company, as defended by the PSPV. In this way, the Socialists renounce their model, which had opened a gap with their Government partners from the Botànic Pact, Compromís and Unides Podem.


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