Will health decide the elections?

It is not difficult to imagine the engineers of the PSOE electoral campaign designing a poster in which a photo of the Madrid health system appears next to another image, but not of Isabel Díaz Ayuso but of Alberto Núñez Feijóo, and the label: "So It will be your health care if the PP reaches the Government ”.

Thomas Osborne
Thomas Osborne
28 November 2022 Monday 22:30
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Will health decide the elections?

It is not difficult to imagine the engineers of the PSOE electoral campaign designing a poster in which a photo of the Madrid health system appears next to another image, but not of Isabel Díaz Ayuso but of Alberto Núñez Feijóo, and the label: "So It will be your health care if the PP reaches the Government ”.

The data from the polls do not mislead about the electoral traction of health care. The latest CIS barometer placed health as the third most important problem for Spaniards, with 27% of mentions (an unprecedented figure), after unemployment (31.4%) and the economic crisis (34.1). Issues as incandescent as the secession of Catalonia or the role of nationalisms registered insignificant mentions: between 0.5% and 1%. And a more prosaic issue such as taxes worried only 1.4%.

In addition, this survey indicated health as the second chapter of public spending (after the investigation) that should grow the most. Up to 92% of Spaniards believe that it is necessary to "spend more or much more than now" in this area. 95% of the voters of the PSOE and more than 99% of those of Unidas Podemos share this opinion, but it is also supported by 85% of the popular electorate and even 77% of Vox followers. Barely 7% of those consulted think that we must continue spending the same, and less than 1% maintain that health spending should be reduced.

The citizen demand is quite clear in this area and is accompanied by a broad rejection of the parties trying to impose their ideological proposals above the demands of the voters. According to the same barometer, 64% of those consulted want political representatives to reflect the wishes of citizens as much as possible, and less than 30% support that the parties cling to their programmatic proposals. And the demand that their preferences be respected also reaches 64% of the voters of the PP and 56% of those of Vox.

The problem with subjecting healthcare to ideological dogmas is that, in Spain, it provides coverage to more than 99% of the population and that means 47 million people, of whom 37 million have the right to vote. In addition, 70% of all of them choose to go to public health for visits to the family doctor, paediatrics or hospitalization. And current perceptions respond to a consolidated vision. The annual survey on fiscal policy confirms that only 25% of Spaniards believe that the necessary resources are dedicated to health, compared to 72% who think that "very few" are allocated. A criterion that is also shared by 63% of popular voters and 70% of Vox voters.

It is true that primary and hospital care reap notable results in the reports from the Ministry of Health, but satisfaction has visibly dropped after the peak of the pandemic (when almost 70% of those consulted were satisfied with the operation of healthcare). . Currently, only 55% of Spaniards believe that healthcare works satisfactorily, four points less than in 2019, before the arrival of the covid. And critical voices are already close to 40%, 15 points more than two years ago.

This drop in the citizen satisfaction index is not accidental. Primary care handles 367 million consultations a year and urgent care in this area exceeds 30 million. In 2019, 42% of primary school patients were seen the same day or the next day and the rest waited an average of 5.8 days. In 2021, only 26% obtained an appointment on the day or the next day, and the rest waited an average of 10.8 days (and nine days in 2022, according to the CIS).

That is why what is happening in Madrid is not accidental either: it is the second community that spends the least on healthcare per inhabitant (below 1,500 euros, compared to most autonomies, which allocate more than 1,700). Andalusia spends less than Madrid, but it is the first in percentage of spending on primary care while the Madrid region is the last. In addition, aiming, as Díaz Ayuso has done, at health personnel can become a boomerang: citizens rate doctors and nurses in primary care, specialties or hospitals with an 8, and satisfaction rates range from 79% and 88%.

For this reason, if Madrid's healthcare system is the mirror that voters who are less ideologically inclined are going to look at when casting their vote, it is likely that this image will not contribute to bringing them closer to a Popular Party whose select tax cuts do not augur an improvement in public services. . And the aggressive ultraliberalism of Díaz Ayuso inevitably contaminates Núñez Feijóo's proposal, blurring it and identifying it with a Madrid experiment in social engineering that has begun to worry the middle classes, who see universal health coverage as a valuable safety net. Hence, according to the CIS, more than 90% of the middle class is also committed to spending "more or much more" on health.