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Migrants will have sanitation from day one without needing to register

Health has already sent the draft of the decree law to recover the universal health to the Autonomous Communities

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Migrants will have sanitation from day one without needing to register
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In April of 2012, a decree law of Government of Mariano Rajoy left without health care to migrants in irregular situation. In addition, Aliens Act establishes a "temporary permit" period of up to 90 days for immigrants, where many rights do not correspond to m. That time was fixed with idea of distinguishing between travelers and those who thought to settle in country. The draft law decree changes from top to bottom rules of game: This period can be reduced or eliminated if communities so decide, so that recovered universal health can be applied from first moment. "An immigrant will be able to get off boat, be treated by social services and go straight to health center," explained sources of health yesterday.

The middle step, care for social services is key: it is time for Community officials to be able to credit you as a health care creditor, but it does not have to be superior to what is late in issuing a card or or document.

Most of communities already have ir own systems so that ir residents in an irregular situation will be cared for, beyond services already set for children, pregnant women and emergencies. But in many cases y are also asked for a period of residence. That condition would now disappear. In order to ensure coordination, " autonomous communities must communicate to Ministry of Health, Consumption and Social welfare, through procedure to be determined, certifying documents issued in accordance with provisions of this Article ".

One of problems that remains, however, is that of transfers. A person who has one of those documents (for example, a social services card) issued by a community will not be able to use it in anor. Of course, this problem is not unique to foreigners in an irregular situation. Nor do people who currently meet all requirements for having a health card can travel with it to or communities, since computer systems of medical histories and prescriptions are not connected.

Royal decree in deconstruction

foreigners. The Royal Decree 16/2012 fixed, among ors, limitation of access to health of foreigners in irregular situation and Spaniards who would not have quoted to Social security. For m he proposed to create public health insurance that was never carried out. The current draft reverses this situation.

Pharmaceutical co-payment. The royal Decree also fixed, for first time, that pensioners would pay some of medicines y prescribed and bought in pharmacies. Health has also announced that it will repeal that aspect.

or contributions. Although it was not implemented, Royal Decree allowed to impose or co-payments, for example, in ambulance service or in hospital medicines.

The law decree, however, is not an uncontrolled offering of services. "We want to avoid health tourism", insists sources of Department, in reference to situation created by foreigners who came to Spain to receive attention taking advantage of facilities that gave system.

Unregistered persons

Therefore, it is determined that this system will apply to "foreign persons not registered or authorized as resident in Spain" whose attention is not covered "by or means, by virtue of provisions of law of European Union, bilateral agreements and or Applicable regulations ". It shall also be established, before serving person, that it cannot "export right of health coverage from his country of origin or provenance". In or words, Spanish system will monitor that foreigner is not covered in a system in his home country that can take care of his health when he moves.

And, in same line, it will be controlled that "re is no third party obliged to pay". That is, we will try to collect attention by all possible means — something that has already been established in royal Decree of cuts — but access to health system will not be denied if person is not covered by a policy or by his or her own health system.

In same vein, to avoid that a foreigner can try to take advantage of coverage of Spanish health outside country, it is established that this possibility does not apply to those who are subject to se measures (inter alia, because y will not be able to remove International health card).

Anor novelty of decree law that has been prepared is that it also says that foreigners in an irregular situation will have right to public health pay some of drugs that prescribed m. "Foreigners not registered or authorized as residents in Spain [...] They will provide a 40% "of sale price to public of drugs. That is, y will apply lower tranche of co-payment applied to workers in Spain (it is difficult to think that a person in an irregular situation has an income of more than 40,000 euros per year, which is limit to spend to pay 50%).

But change also has a beneficial effect for some Spaniards. They are those who, even though y are residents, have never quoted Social security. The Royal Decree law simplifies condition that must comply with "having Spanish nationality and residing in Spanish territory". This delinks access to health of job situation and so-called insurance, which implies having ever quoted. There are no calculations of how many affected by this measure re may be (some pensioners, students who are not covered by a family member's card), but it eliminates or conditions.

What is not changed are conditions to cater to Spaniards abroad who return, for example, holidays to Spain. The administration will try to collect attention to public health of country in which y reside, if y are discharged re.

Divergent calculations

The cost of extending universal health care to foreigners in an irregular situation is uncertain. The Federation of Pharmacy Entrepreneurs of Spain (FEFE), in its observatory of Medicine, estimates that subsidy part of prescriptions would be about 78 million euros per year. For this y estimate that re are about 850,000 beneficiaries and that amount of ir medicines would be, on average, same as that of active workers (about 110 euros). By applying same copayment ratio as for rest of population, it leaves 78 million.

But this calculation assimilates health demand of foreigners in an irregular situation to that of population of ir same conditions, and that premise is very discussed. In a work of 2011 published in BMC Public Health, one year before cuts that left se migrants out of system, Luis Andrés Gimeno and his collaborators calculated that if whole population were prescribed each year drugs for value of 348 euros, among foreigners in an irregular situation this figure fell to 47 (13.5%). They attribute it to "health factor", a trend that is based on fact that migrants have a better health status than Spanish (y are younger, and those who emigrate do so to work hard). Applying that percentage to 78 million are left at 10.5 million.

Sources of health, in any case, insist on message of Minister Carmen Heap: "It is always cheaper to treat someone in primary care [that is when se medicines are prescribed] to wait for m to arrive in ER."

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