The president of CSIF: “The Government wants Muface to die”

The Muface model, which has been guaranteeing healthcare for public officials for more than 50 years, is going through its most critical moment. The tender to renew the 2025 agreement was void, generating deep uncertainty among one and a half million mutual members and their beneficiaries. Now, all eyes are on two key dates: January 15, when the deadline for the second tender ends, and January 31, when the current agreement expires, leaving the health care of thousands of people in the air. In this interview, Miguel Borra, president of the Independent Trade Union Center and Civil Servants (CSIF), analyzes the implications of this scenario, denounces the lack of planning and transparency on the part of the Government, and warns about the risks of a possible collapse of the National Health System if the model disappears.

What situation is the Muface Model currently in? And why?

The situation we find ourselves in is extremely worrying. For the first time in history we are faced with a concert with a tender that has been left empty. No insurer wanted to attend because they understood that what the Government offered was not enough. We cannot forget that, in the first tender, on October 19, the Executive offered an increase in the premium of 17%, when its own General Management of Muface had requested that it be 24%. As a result, the tender was void. The Government then began to ask the insurers, giving them until December 4 to indicate under what conditions they would be willing to provide the service. By the way, we do not know what the insurers responded because the Government has not made this information public, nor has the AIReF report, which they commissioned many months ago on the model. Then a second tender was issued, the process of which concludes on January 15.

Precisely, attention is focused on two key dates: January 15 and 31, when the bidding process concludes and the validity of the current concert ends, respectively. What is the feeling of the users?

Exactly, the current concert ends on January 31, which generates tremendous unrest among mutual members, who see how the end of their health care through insurers is approaching. They do not know what will happen with the appointments they have in the coming weeks, with their long-term treatments or, worse still, with serious medical processes, such as oncological treatments, where they do not know who will provide them with healthcare in the near future or if it will be possible. the frequency of your appointments. Thus, at this time, there are a million and a half people, including holders and beneficiaries, who do not know what will happen to their healthcare on January 31.

From Health they consider it viable to integrate mutualists into the public system. What implications would this decision have for officials? And for the public health system?

The integration of mutualists into the public system would generate an increase in waiting lists, collapse certain areas of the National Health System and seriously affect its sustainability. In fact, there would be an increase of 2.1% in the population to be served by the autonomous communities, while their health budget would only increase by 1.8%. Furthermore, more than 30% of mutual members are over 65 years old, compared to 20% of the general population served by the National Health System. This implies that this population requires more healthcare resources than are planned to be allocated. For example, retired mutual members pay 30% of their medications, a significant difference compared to what happens in the public system. All this means that the Government is making an oversimplified analysis of the impact that the disappearance of Muface would have, and several autonomous communities, such as Madrid and Andalusia, have already warned that they would not be able to absorb these new users due to the lack of resources, infrastructure and health personnel.

He commented that the first tender took place on October 19, less than two months before the end of the contract. Do you think that this delay in deadlines responds to a negotiation tactic, a lack of political planning or a strategy to end the Muface model?

It could be the last two things. This Government seems to be divided into two very different parts. On the one hand, the Ministry of Health issued an 18-page report that practically liquidates a 50-year model of public-private collaboration, a model that has given good results and that was not under public discussion. On the other hand, the Government knew perfectly well that the current agreement ended on December 31, 2024, but the new tender did not come out until October 19 of that same year. This shows a lack of real interest in moving this model forward. Furthermore, although Mónica García has not explicitly stated that she wants to end Muface, there are clear indications. For months we have denounced a neglect of functions by the Government in the management of health care for civil servants. officials. We have taken our complaints to the Ombudsman, the Congress of Deputies and we have met with various parliamentary groups. These actions have generated certain changes in the Government’s initial approach, but we continue to see a lack of transparency and an attitude that seems to seek the model to disappear due to starvation. For example, the AIReF report on Muface has not been made public, nor have the insurers’ responses following the consultation. In addition, rumors and hoaxes are circulating that generate uncertainty among mutual members, such as that they will be forced to choose between the public or private system definitively, or that, if there is no tender, they will be automatically transferred to the National Health System. All this increases distrust and discomfort.

In your opinion, how should the Government act to ensure a viable solution?

The first thing is to bet on transparency. The Government must make public the AIReF reports and the insurers’ responses so that we can analyze the real needs of the model. Secondly, negotiations must be initiated with all parties involved, including new insurers, to explore viable solutions. It is also essential to improve the financing of mutual societies. Since the Covid pandemic, mutual societies have not received the additional funds that were allocated to the autonomous communities, which has contributed to the deterioration of the model. In addition, structural problems must be addressed, such as a lack of infrastructure and healthcare personnel, which cannot be resolved overnight.

The mutual model has been working effectively for 50 years. It has been an example of public-private collaboration that has guaranteed quality health care for officials. The Government must put aside any ideology that seeks to destroy this model and focus on protecting the rights of citizens. They must put themselves in the shoes of those mutualists who do not know what will happen to their cancer treatment, their pregnancy or their medication in the coming weeks. The uncertainty generated by this management is unacceptable, and the Government has the responsibility of guaranteeing a solution that maintains the stability and quality of the system.

What concrete actions do you propose if an agreement is not reached before January 31?

If an agreement is not reached, we do not rule out any measure. With the rally on December 14 in front of the General Directorate of Muface, where more than 50,000 people from all over Spain raised their voices to defend the mutualist model, we showed that we are willing to mobilize and continue to exert pressure for the Government to act. We will also monitor that insurers fulfill their obligations until the last day of the current concert. But, above all, we will continue to defend mutualists, taking our demands to all the necessary bodies and demanding solutions to prevent this situation from leading to a collapse of the system.