We need to know the informal demoler AIReF (Autoridad Independiente de Responsabilidad Fiscal), in which the increase of public gas in temporary incapacity (IT) is evident, one of the main advantages of the Spanish system of public administration.
He represents the second mayor of the Social Security Departmentwith a figure of 16,500 million euros in 2024, surpassed only by pensions.
This provision guarantees the economic protection of workers when an illness or injury temporarily disrupts the termination of their work activity.
This figure does not include gas for part of the companies, which assumes a large majority of the complement that equates to low pay with who is active.
The information points to the deterioration of the main IT indicators.
The number of bajas increased by approximately 60% between 2017 and 2024.. And the average duration of processes has significantly increased in the pathological conditions of large public gases (especially mental disorders and muscle diseases) in connection with the deterioration of the lists of hope of the National Health System (SNS).
Unlike gas in pensions, which is increasing mainly due to the demographic problem, in the case of the lowlands, everything indicates that poor health is not the main reason that decides the increase.
In other words, what most people have been told, by giving out bass, how it prevents them from working and for a longer period of time, no explanation because there are more sickor head gravedigger, an exception during the Covid period.
For other reasons.
The president of the Autoridad Independiente de Responsabilidad Fiscal (AIReF), Cristina Herrero, during her consultation in the Commission for Monitoring and Evaluation of Pacto de Toledo del Congreso actions.
EFE
From my more than three years of experience as a doctor, manager and politician, I would say that the combination of various factors created a perfect storm.
On the one hand, the evolution of the regulatory framework has brought a progressively more guaranteed focus since 2018, reversing previous restrictions and extending economic protection during episodes of temporary incapacity.
Without forgetting the relevant paper on the collective benefits in this greater generosity, the inclusion of rewards that substantially increase the economic coverage during IT and in many cases follow on from compare performance with usual pay.
And secondly, the deterioration of the SNS and, above all, primary attention.
Before the pandemic, 2019, an offer was obtained from the head doctor for the same day or the next day, in fact they are new days. And the same tendency is observed in access to a specialist, diagnostic tests or a surgical list.
The combination of these factors renders ineffective any means of control by the part of the medical inspections in each community or the INSS and cooperating Mutual organizations at the state level, which are experts with whom the System is aware to avoid abuse.
As a society We have an ethical obligation to reverse this disturbing trendbecause this gas build-up in temporary incapacitation is unsustainable over time, ensuring continuity, at least at the protection levels we know.
In other words, to be able to continue to protect those who really need it, during the time they need it, or improve control, or carry linear and universal trackswith the injustice it implies.
Once you check the diagnosis, you can treat the patient.
What is certain is that they come with a menu of “recipes” right from the start. AIReF also does this in its own way, as do many other social agents, but either they are not allowed to be implanted at all, or those that have been put on the market are not much less effective.
“The fragmentation and decoordination of the Spanish health system creates risks of overuse and unnecessary prolongation of processes in the absence of enhanced supervision”
I mean such drugs improve the information systems available to physiciansor incorporate artificial intelligence hardware to make your work easier.
For much information that is optional in terms of the patient’s symptom history or work status or optimal clinically stable time for their pathology, a test that lasts three months or longer is needed, this information will be of little use.
I am not saying that there is no need to do these and other measures, such as improving control by medical examinations or mutual health workers, strengthening their qualifications, improving prevention and protection of workers’ health, etc. So yes.
But honestly I believe that with him we will reverse this worrying upward trend.
We are asking ourselves to maintain the level of welfare and social protection we have achieved over the last fifty years by carrying out this deep reform of the basic principles of our democracy and our social shield, including the temporary incapacity benefit.
And when it comes down to it, it’s hard to debate in depth to reach a consensus that would suit a large social majority. Something that is practically unthinkable in the current political situation.
The first issue to be discussed is the structural deficiency caused by the separation of the financier, INSS, and the person determining payment, the primary care physician.
This configuration, supported by the autonomous organization of the Spanish health system in ten health services, generates risks of overload and unnecessary prolongation of processesin the absence of enhanced supervision and coordination.
“This question should be prioritized on the lists of hope by those who are low, over others who do not exist in similar clinical settings, through the introduction of external agents to the SNS.”
The other big question for discussion is whether you should deal with the same thing while staying low when it works, especially for short periods. Let’s say mainly from one to five days, where the subjective component decides.
In these cases, the capacity of the optional or any other control mechanism is irrelevant compared to the necessary credibility that must be provided to the patient. actually Only your own juiciness determines your work capacity.
The restoration of the 100% salary supplement for public employees in an IT situation (Actual decree 956/2018) increased the probability of starting a salary by 40%, demonstrating the importance of the degree of generosity of performance over the impact of their IT processes.
Third, the debate on whether lists would hope to prioritize access to specialists or tests for those in the lower class over others who do not exist in similar clinical settings, through the introduction of external agents to the NHS who can provide this healthcare, such as mutuals or private companies.
Or anyone else who may be waiting for a request.
It is said that if you suffer from pain in the knee or on the slope of resonance, you have to wait alternately for a number of months without being able to work, just like someone who cannot be bothered by the disease, whenever and wherever this double system does not harm him.
It’s not about placing them immediately until they are Leave them from the general list and go to another specific one.
There are no magic or perfect solutions to solve something as comprehensive as finding a balance between equally effective protection that guarantees the continued sustainability of the social security system. Each idea that can be adopted has its benefits and risks that need to be analyzed and discussed.
But do not touch them or look away, do not prevent us from carefully protecting the sick workers. And also the economic health of our companies, which are ultimately what can guarantee jobs.
*** José María Antón is the vice-consejero de Humanización Sanitaria of the Community of Madrid.
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