medo, tenhamos medo
In Spain, talk about the “unsustainability” of universal health care rose in the early years of the crisis. While some cuts were going to be inevitable given the demands of the troika, the conservative “People’s Party,” elected to power in the Spanish parliament in November of 2011, went further. In the face of the demands of the troika to slash health care expenditures, the party proceeded to pass, by royal decree (thereby avoiding parliamentary debate), a new health care law that represented perhaps one of the largest changes in Spain’s national health service since its establishment in the 1980s.
The law did several things, such as increase co-payments and limit the ability of illegal immigrants to access the health care system. Most radically, however, it quietly shifted the nation away from a truly universal scheme, financed through taxation, to a contributory one. Pensioners, for instance, could have access to the system only if they had contributed to it, while those over age twenty-one who had not contributed to the social security system needed to demonstrate an absence of income to obtain access to health care. In fairness, the system remained by and large a universal one, particularly if compared to, say, the United States. But the meaning of what had transpired was clear enough. “Spain’s public health service is to shift from one that provides universal coverage through general taxation,” reported Aser García Rada in the British Medical Journal, “to a system funded through social security contributions.”
Austerity and the Unraveling of European Universal Health Care, na Dissent
