Currently, there are 1,835,876 residents in Andalusia with health policies, compared to 1.2 million ten years ago. This means that 21.60% of the Andalusian population has private healthcare, compared to 19.5% before the pandemic. Most of the business pie is monopolized by SegurCaixa Adeslas, with 34.5% and a turnover of 493 million euros. The other two companies on the podium are Asisa, with 320 million and 25.2% of the market, and Sanitas, with 216 million and 17% of the total turnover of the sector in 2021, according to data from ICEA, the Cooperative Research service between Insurance Entities and Pension Funds.
health in Spain and Andalusia?
Health insurance has grown steadily in Spain and Andalusia since the end of the 1990s, and our forecast is that it will continue to do so in the coming years. For 2022, our forecast is to close the year with growth similar to that of previous years, supported by the increase in administrative mutual insurance premiums and with a moderation in the growth of private insurance due to the effect of the economic crisis that is beginning to affect families and companies. Currently, 24% of Spaniards and 21% of Andalusians have health insurance, so there is ample room for growth in the sector. Today, health insurance is a very attractive product because it is the gateway to private healthcare that offers high quality care, has notably increased its hospital offer and has the most advanced healthcare technology.
In Andalusia, the health insurance sector has been growing in recent years between 3 and 5%. In the last year it grew by 6%. How do you foresee the evolution of the sector in 2022?
Health insurance grew in Andalusia by 6% in 2020 and 5.5% in 2021. We expect growth in 2022 to be similar, but it is very difficult at the moment to make any medium-term predictions. The situation of economic uncertainty that we are experiencing and the consequences of the Russian invasion of Ukraine will have an impact on our sector that we cannot yet calculate.
How have health groups that work for health insurance companies endured such a strong increase in policyholders?
In recent years, the hospital sector has been undergoing a process of concentration that has given rise to the birth of large groups, including the HLA Hospital Group, with a presence throughout the country and with a great investment and development capacity to increasingly attend to more insured. This muscle has allowed us insurers to incorporate new policyholders and, at the same time, improve our care offer and offer our policyholders access to the most advanced diagnostic and treatment techniques.
Isn’t there already saturation in hospitals and specialist doctors who work with health policies due to the growth of the population with private health policies? (In Andalusia we have gone from 1.6 million in 2019 to more than 1.8 in 2021, 21% of the population).
There is no saturation because hospital groups have increased their supply to meet demand. In the case of the HLA Group, which has seven hospitals in Andalusia, in recent years it has added new clinics and medical centers to its network in Cádiz, Jerez, Almería or Málaga and plans to open a new medical center in Seville to expand its portfolio of services and its ability to serve new policyholders. Therefore, private healthcare in Andalusia has the capacity to take on the growth of health policyholders and offer better care each time.
Do health policies continue to cover Covid patients even though pandemics are normally excluded from these policies?
In March 2020, Asisa and the rest of the health insurers decided to cover Covid-19 despite the fact that pandemics are expressly excluded in the conditions of all health insurance. It was a sign of responsibility and a way of assuming our commitment to caring for people’s health at a very difficult time. Since then, we have maintained Covid coverage for all our policyholders. In the case of the Asisa Group, we have treated more than 300,000 people for Covid19 and have covered the hospital admission of more than 12,000 policyholders. In any case, the clauses that exclude coverage in the event of a pandemic or epidemic remain in force, since, from a purely actuarial point of view, it is not possible to calculate the insurance premiums to deal with a pandemic.
Years ago, citizens with private health policies had exemptions. Taking into account that these decongest public health and save money for the Administration, should tax relief for health policies return?
It is a decision that corresponds to the Administrations. At this time, there are tax advantages for hiring by companies and from the sector we have raised on several occasions the need to promote health tax relief for families for contracting private health insurance, at least for income lower (less than 30,000 euros). It is evident that private insurance relieves the public sector, relieves its waiting lists and, according to data from the IDIS Foundation, causes savings of between 4,689 and 12,676 million euros each year depending on the use that the insured make of health public. Promoting the health tax relief would allow insurance contracts to be increased by between 5 and 20%, which would mean additional savings of between 2,000 million and 8,000 million euros for the public system, according to IDIS calculations. In addition to this saving in care costs, the Administration would offset the cost as a result of the increase in taxation of the sector as a whole by increasing the volume of total premiums and care activity.
Have health policies increased with Covid?
Health policies have an annual duration and are reviewed each year to adjust them to the rise in the CPI and the evolution of expected costs once new coverage is incorporated. In the case of Covid19, the insurers have assumed the costs of care for the insured and the costs derived from the new measures and protocols to guarantee the safety of patients and health professionals, which in most cases do not have been passed on to the insured. In the case of Asisa, we have also incorporated new coverage and services, including access to telemedicine and a Psychoemotional Care Service.
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