Canary Islands has dropped three places in the ranking of regions with the highest degree of healthcare privatization published each year by the Federation of Associations for the Defense of Public Health (FADSP) and now occupies seventh place, shared with Asturias.
From 2019 to 2023, Canary Islands had been in fourth position in privatization of the health system, only behind Madrid, Catalonia, and the Balearic Islands. And, like them, with a high degree of privatization.
In 2024, the same three regions remain at the top, although the Balearic Islands have surpassed Catalonia, but now Andalusia, Aragon, and Valencia have overtaken Canary Islands in measures to privatize their healthcare, and the islands have gone on to be at an "intermediate" level.
These are the results of the tenth report The Healthcare Privatization of the Autonomous Communities, carried out by the Federation of Associations for the Defense of Public Health (Fadsp) with the latest available data from the Ministry of Health, the National Institute of Statistics (INE), the Health Barometer, and the IDIS Foundation, most of which are from 2023, although there are also some from 2022.
The report has analyzed variables such as the percentages of the total population that, being covered by civil servant mutual societies, chooses healthcare through private insurance, the percentage of private hospital beds or consultations with private professionals, as well as the per capita healthcare expenditure on private insurance, out-of-pocket expenses, or contracting with private centers.
And from this, it extracts that the degree of privatization of Spanish healthcare that began a few years ago continues to accelerate: "first, the excuse of the economic crisis was used, and then the pandemic," the spokesperson for the Fadsp, Mariano Sánchez Bayle, criticized at a press conference.
Navarre, Extremadura, and Castilla-La Mancha, the least privatized
From the evaluation that the FADSP has made of these variables, the report shows a general degree of privatization of 21.58 points out of a maximum of 34, which is 1.41 points more than a year ago. But not all regions are the same.
The report classifies them into three degrees of privatization: higher, intermediate, and lower.
Thus, 3 of the first 4 regions with the most privatization in 2024 were already in 2014, and have remained in the successive reports of the Federation from 2019, 2020, 2022, 2023, and this year, only in different positions except for one: Madrid, which has been topping the list from the beginning.
The other three autonomous regions that are at the top of the table are the Balearic Islands, which this year rises to second place; Catalonia, which falls to third, and Andalusia, which jumps from sixth to fourth place by experiencing "a high increase in its privatization."
Aragon, Valencian Community, Asturias, Canary Islands, Murcia, Castilla y León, Cantabria, Galicia, Basque Country, and La Rioja are located, in this order, in the intermediate zone.
In the group with the lowest level of privatization, only Extremadura remains in all the reports, but two years ago it ceased to be the one with the lowest score; this 2024, it is placed ahead of Navarre, which closes the list, and behind Castilla-La Mancha, which repeats position.
However, the report draws attention to those that have experienced the most striking increase: Cantabria, which increases 6 places; Murcia and Aragon, which climb 4; Asturias (3), Andalusia and the Valencian Community, which rise 2, and the Balearic Islands and the Basque Country, which increase 1.
On the contrary, those that have decreased the most are Navarre, which after rising 8 places in 2023, this 2024 has fallen 12; Galicia (5); Canary Islands (4); La Rioja (2), and Catalonia 1. Only 3 CCAA maintain the same position as in 2023 (Madrid at the head and Castilla-La Mancha and Extremadura in the last positions).
Madrid residents, Balearic Islanders, and Catalans, those who spend the most on insurance
The report also specifies what each Spaniard allocated to contracting private insurance, which in 2024 rose to 178.52 euros on average, although here too there is a huge difference by region.
While Madrid residents spent 362 euros, Balearic Islanders 312, and Catalans 294, Navarre residents barely spent 104, Murcia residents 108, and Cantabria residents 109; in between, in the Basque Country they spent 194 euros, followed by Aragon and Basque Country (191) and Andalusia (175).
It also echoes the so-called out-of-pocket expenses, those that are dedicated to what public health does not cover, such as dentistry, and which on average reached 504.23 euros.
But while in La Rioja they reached 594, in the Valencian Community 575, and in Catalonia 560, in the Canary Islands they barely spent 424 euros, ahead of Murcia (426) and Castilla-La Mancha (434).
Mutual societies cover an average of 3.61% of the population, but Asturias leads the list with almost double (6.3%), followed by Andalusia (5.7%) and Aragon (5.1%). At the other extreme are Navarre (0.7%); Basque Country (1.4%) and Catalonia (1.5%).
Concerts accounted for 6.31% of health spending, although in Catalonia it shot up to 22.6% and in Madrid to 12.3%, while Castilla y León remained at 2.9% and La Rioja at 3.4%.
On average, in Spain, 18.76% of hospital beds are in private centers, although the Canary Islands almost doubles that figure (33.19%), slightly more than Cantabria (31.98%) and Madrid (30.2%).
At the other extreme are La Rioja (4.83%); Extremadura (5.07%) and Castilla-La Mancha (6.01%).
Finally, the report includes consultations with general practitioners in the private sector, which were attended by an average of 24.75% of Spaniards; by region, Catalonia topped the table (33%); Andalusia (31.9% and Castilla-La Mancha (30%), unlike the Basque Country (16.8%) Navarre (17.3%) and Castilla y León (17.3%).
