Spain forced to pay for costs of expat healthcare
21 September 2005, MADRID — A European Court of Justice ruling is forcing the struggling Spanish healthcare system to provide treatment for the rising number of foreign residents.
21 September 2005
MADRID — A European Court of Justice ruling is forcing the struggling Spanish healthcare system to provide treatment for the rising number of foreign residents.
As prime minister Jose Luis Rodriguez Zapatero's Socialist government faces a political crisis over the rising costs of free healthcare for new arrivals, the ruling will be less than welcome.
The court ruling relates to the case of Annette Keller, a German living in Spain, who sued the Spanish government for failing to cover the costs of her cancer treatment in a Swiss hospital.
Keller was diagnosed with cancer during a month-long visit to Germany and then referred to a Swiss hospital.
According to EU regulations, the Spanish welfare system (INSS) is obliged to cover the costs of the treatment of EU nationals during stays in other EU countries.
The INSS paid for the treatment in Germany, even though it was more expensive than in Spain, but refused to reimburse the money for the Swiss medical treatment, as it is not in the EU.
The court ruled that the member state of affiliation "must place its confidence in the doctors of the member state of stay" and abide by their decisions even if this means treatment in a non-member state.
It comes after a report last week suggesting Spain was struggling to pay for extra healthcare and education for the 4 million new arrivals in the past five years.
In this time, the population has increased by 10 percent to 44 million.
No other country in Europe has had to cope with such a large influx in such a short time, placing a huge strain on public services.
The strain is made worse by the large number of tourists — 55 million each year.
If they fall ill they are entitled to free healthcare and some take advantage of this.
A former British consulate official in the Basque Country said: "You'd be surprised to know how many elderly British tourists have taken to slipping off the gangway as soon as they get off the ferry, just to get hip-replacement therapy."
Doctors have taken to calling these people "medical tourists".
It places particular strain on Valencia, the Canary Islands and Andalucia which receive the majority of visitors. They are demanding extra funds from the government.
Madrid funds the EUR45 billion healthcare system and regional authorities provide services.
It has created tensions between Zapatero and regional allies in Catalonia, which demands a new tax-sharing regime with the central government to increase the region's fiscal autonomy.
In Madrid, with 1 million new arrivals a year, healthcare services are stretched to breaking point.
The regional government is demanding EUR 1.7bn extra to cut hospital waiting lists and is short of 50,000 school places.
Zapatero has offered EUR 1.7 billion to cover a third of the EUR5bn shortfall.
He expects regional leaders to curb costs and raise local taxes to find an extra EUR 1.8 billion — a move which has met with huge opposition.
Subject: German news