Europe, Globe

Health reform in Spain… anti-immigrants

The Royal Decree-Law approved by the government of Spain on 20 April for the health sector, also amended the Immigration Act. The “undocumented” will have to pay for their treatment.


Javier Duque

Any immigrant who does not have a residence permit in Spain and who, for example suffers from leukaemia can at the present time get by, but from the 1st September 2012 the government will no longer provide free treatments of chemotherapy, radiotherapy for those without the permit.

Although it sounds harsh, it’s reality. On the 1st September the measure will be enforced because it is one of those included in the “Royal Decree-Law 16/2012 on urgent measures to ensure sustainability of the National Health Service and to improve the quality and safety of its services”.

The reform also includes control of the so-called “health tourism”, the co-payment for medications in accordance with citizens’ income, it will enhance the use of generics, and packages will last only for the duration of the treatment, as well as creating a portfolio of common services which eliminates the differences between the service received by the Spanish in each autonomous community.

But undoubtedly the most controversial topic raised is that which affects non-EU foreigners, who will no longer have a card for health insurance; instead the card’s  only purpose will be for the sake of registering on the electoral roll.

Because of this it lays down a number of requirements, such as having fiscal residence, to have paid taxes in Spain and to have lived there for six months and a day.

It will only exempt people who do not meet the above requirements if they are under 18 years old, pregnant or in a case of emergency due to serious illness or accident.

The statements made by members of the government intending to justify the measures have been surprising, especially since they seem to focus on immigrant groups. The Health Minister Ana Mato further stated that the health card “is for the Spanish.”

The Health Minister of an autonomous region, ruled by the same party as the national government, went even further by claiming that free healthcare has been fundamental in encouraging the following effect: “Many people boarded a boat because they knew that Spain had guaranteed health care”.

Another of the reasons pointed out by the Government is that immigrants often come to Spain only to register themselves on the electoral roll, get a health card and then be able to undergo an operation.

However, this unfounded belief that immigrants excessively overuse health services is fully exemplified by figures which show that is not true.

A study carried out in a sector of the Community of Madrid, (where 20% of immigrants reside), found fewer consultations and hospitalizations of foreigners.

In pharmaceutical consumption, where the average is €381 per person per year, the difference between natives and foreigners is abysmal: €96.50 Euros for the immigrants and €446.40 for natives.

The same applies to emergency room visits: the number of visits corresponds to the 40.6% of the immigrant population in comparison to 44.6% of the native population. The reality is that humble immigrants do not come for the so-called “health tourism”; a concept which makes EU countries such as Germany or England rich.


Before the controversial reform there have been many groups and associations who have publicly stated their opposition to government’s decision.

“Caritas” claim that they are also very concerned about the current economic and social situation but believe that some decisions can restrict the rights of the people who are supposed to be supported by society.

Meanwhile, “Amnesty International” described the reform as an “absolutely regressive” measure and recalled that Spain is among one of the few countries which has ratified the International Covenant on Economic, Social and Cultural Rights; which requires respect the right to health without regression or discrimination.

The opposition leader, Alfredo Perez Rubalcaba said that the reform has “xenophobic overtones ”, and that it is ‘cruel’ and ‘useless’ because some health professionals have already stated that they will treat ‘undocumented’ immigrants.


As mentioned above, the “undocumented” will still be treated in cases of emergencies. But would it not be better to eradicate a disease from the outset rather than allow it to deteriorate and result in hospitalization?

Everyone knows that it is a more economical approach to tackle a disease from the beginning rather than treat it later or confine it. For example, the health of sufferers of HIV, tuberculosis and other similar illnesses will deteriorate if they are not given treatment from the beginning and they may only finally end up being treated when their life is in serious danger.

Similarly, with regards to untreated contagious diseases, the risk of contagion for others is much higher, and thus the final medical expense much larger.

These are therefore measures which discriminate against a sector of the population that contributed greatly to the growth of Spain during its boom years that have only been interrupted now by the global crisis.

A report last year concerning the contribution of immigrants to economic growth, the social security system, and to the use of social services concluded that they make a positive net contribution, and that they proffer much more than they receive.

The study concluded that even immigrants in unusual situations pay into the system; they indirectly pay taxes, boost consumption and perform tasks which allow native females to enter the work force.

Photo Blog El Dia de Maria

Furthermore, the study again highlighted how those arguments regarding the use and abuse of the welfare system by immigrants are unjustified.

A report which may well be read to current members of the Spanish Government encouraging them to reverse this discriminatory measure which is due to take effect in less than three months, as it will affect many of those who helped the country grow;  and it is important to remember that those “many” who are people too.

(Translated by Emma O’Toole)

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