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Asunción Gómiz, Professor at ISSA School of Management Assistants of the University of Navarra

A supposed saving without a serious report


Tue, 19 Jan 2016 12:20:00 +0000 Published in Navarra Newspaper

The new controversy that has arisen in recent days, which seems to have momentarily eclipsed those caused by the department of Education, is the planned elimination of the agreement between Osasunbidea and the CUN on the health care of the employees of the University of Navarra.

In the explanations offered by the politicians responsible for Navarra's healthcare system, it has been indicated that the decision is obligatory because it responds to a commitment of the agreement Programmatic . Well, this pact, which supports and -it is assumed- "limits" the government action of the current executive, signed in July last year by Geroa, EH Bildu, Podemos and Ezquerra, is a mixture or amalgam of desires, justifications and commitments that are not always totally compatible. A pact between four such different parties is not easy to interpret. In any case, from its simple reading it can be seen that it contains at least four types of formulations: a) ideological positions (so much more generic as it was necessary to reach coincidences), b) reproaches to the previous governments (it is already known, they have done everything wrong); c) objectives to be reached in the middle deadline (four years do not admit the "long"); and, d) concrete commitments. Well, on the topic that concerns us, in point 2.4, No. 29 ("Health"), a specific commitment was included to "analyze in legal and economic terms the advisability of maintaining the CUN's agreement for the health care of its workers and families".

It was agreed, therefore, to terminate the existing agreement with CUN, unless legal or economic reasons indicated that it would be advisable to maintain it. Seen in this way, in its most elementary formulation, and having cleared up any doubts about the existence of legal obstacles to the cancellation, which do not seem to exist, the agreement depends solely on a question of cost savings. This, of course, without such profitability being achieved at the expense of harming the rest of the commitments acquired in subject on health.

The signatories of the agreement committed among themselves and before the citizens of Navarra that their decisions would be aimed at considering health, above all, as "a human right and a fundamental resource for people's lives" and that they would be based on respect for the principles of universality, equity, solidarity, transparency, efficiency, good practices, etc. (cfr. point 2.4). And, as an expression of such values, they obliged that the government action in the subject would respect the essential goal of promote and maintain the quality of the public health service without measurements or downgrades "in terms of economic profitability".

If we look exclusively at the programmatic agreement , we can now ask ourselves whether the management of topic carried out by those in charge of department of Health is faithful to what was agreed. Well, from the explanations offered in Parliament so far, it can be deduced that there is no in-depth study on the impact of the suppression of agreement on the current public service and on its capacity to absorb the new group (approx. 7,100 people). Nor have the organizational measures to be adopted to assume the task with responsibility, possible new hires, expansion of services, restructuring of systems and resources, adequacy of facilities, etc., been made known.

Where do the savings figures offered by the Health Department (2 million, it has been said) come from? Where can the report that so concludes be consulted? What is the actuarial method used to measure the always difficult task of predicting future costs based on circumstances such as loss of health or illness? Is there a study on the group and their care needs based on pathologies that are already chronic or foreseeable due to age or risk factors? Will it be necessary to adapt the emergency rooms of the CHN again? How will the topic have an impact on the already painful waiting lists? How will action be taken to avoid their undesirable increase? How much will these measures cost?

Without access to the economic reports that advise the suppression of the agreement with CUN, mandatory with the programmatic agreement in hand, we will have to continue suspecting that the real reason for this way of proceeding is ideological. The same madness as always, cancer of this country, on account of nothing.

The old policy is still alive and well.

By the way, neither my family nor I are beneficiaries of agreement with CUN, but simple and grateful users of the public management healthcare system.