A 66% (two-thirds) of the physicians working in private mutual companies do not feel well treated by insurers, according to the survey ‘Estudi dels professionals de la medicina privada’ conducted by the. Consell de Col.legis de Metges de Catalunya (Catalan Medical Association). by the end of 2021. Paradoxically, the insurance companies are experiencing a boom in policy contracts life insurance policies: all over Spain, the health insurance grew by 7% in 2022, according to the Spanish Union of Insurance and Reinsurance Entities. (Unespa). Catalonia in first place and then Madrid are the two communities in which they are growing the most. Unespa invoiced 2,000 million euros in Catalonia in 2020.
“Despite the fact that there has been a very large growth of mutuals in recent years, many of them have frozen fees. Some have had them frozen for 25 or 30 years,” explains Pere Torner, president of the section of free insurance physicians of the Col.legi Oficial de Metges de Barcelona (COMB). This, assures this traumatologist at the Clínica Sagrada Familia, places many physicians at “borderline situations.” in which they even end up losing money.
Torner points out that private physicians have a “very high volume of expenses.” because they pay for the office, the nurse, the instrumentalist, the assistant…. For example, for a family and community medicine visit prices range between 14 and 18 euros gross, but 10 years ago they were between 13 and 17 euros gross. medical-surgical specialty visit, the amounts range from 19.5 to 27 euros gross (18 and 26 euros gross a decade ago). And for a surgical intervention with laparoscopy, between 217 and 570 euros gross (225 and 470 10 years ago).
“But that’s not what we physicians charge because we have to bear all the expenses. Sixty to 70 percent of the income goes in expenses.” he points out. Another example: Torner, as a traumatologist, makes prostheses in private practice. “I charge between 400 and 800 euros, but that includes all the treatment of the patient: all the visits in the clinic, all the equipment. I receive half of these figures.” he complains.
Policy war
The COMB already once warned that the increase in policies The increase in private-sector policies may be detrimental to the quality of care. In recent years there has been a policy war between companies to see who can offer the best quality of care. the cheapest, which leads to offer 12 or 15 euro policies per month, which “consolidate precarious models that jeopardize the quality” of the sector, according to the COMB.
Physicians denounce that the economic loss experienced these years has been paralleled by the “profits” of the insurance companies, According to Torner. “The companies every year grow a lot in their profits and we lose every year, because fees are not updated and expenses go up.” he concludes.