Dear colleagues at Physicians for a National Health Program:
As you may know, the Federation of Associations for the Defense of Public Health (FADSP) is an organization of Spanish health professionals which for more than 25 years has sought to protect and improve our national health system, of which we have reason to be proud.
Through educational programs and other activities, the FADSP strives to strengthen and safeguard our integral and comprehensive public health system. We advocate sound public health policy and the effective practice of primary care, specialist care and hospital care; the use of all kinds of modern diagnostic, therapeutic and surgical procedures; and the provision of rehabilitation services for the benefit of all of our citizens, regardless of their level of income, their profession, cultural level or regional origin.
This does not mean that our system is perfect, of course, or that it lacks important areas for improvement. But its achievements are many and it is highly cost-effective: our country dedicates only 6 percent of our GDP to keep the system running.
Our health system is basically free at the time of use, except for a prescription co-payment of 40 percent. The co-payment is waived for seniors.
The funds for financing the system come from taxes, particularly income taxes, so the burden on each individual depends on their income level. This allows the wealthy to show solidarity with the weak, those who have jobs to express solidarity with those who are unemployed, the younger to help the older, and those who enjoy good health to assist the sick.
Doctors, nurses and other health professionals are public employees, although they can practice privately in the afternoons. They perform their work in primary care centers in towns, villages and cities all over the country or in modern hospitals that possess the latest medical technology and that meet the highest world standards.
The impact of all this on the health of the Spanish people is positive and rewarding. Among other indices, Spain has one of the highest life expectancy rates in the world and is among the lowest in infant mortality.
Despite these achievements, our national health system, like others around the world, is subject to pressure of all kinds by institutions, individuals and sometimes even governments who, under the mantle of pro-market ideology, want to erode, weaken and eventually destroy our system and replace it with a private, for-profit health care market.
They push forward their policies in many different ways, claiming the public system is intrusive, expensive and inefficient. They charge our system is manipulative, limiting the individual freedom of doctors and patients, and that it undermines the doctor-patient relationship.
They also advance their agenda by working to cut the funding to the system, thereby hindering its activities, and by splitting or fragmenting its programs, fostering problematic gaps between the funding mechanism and providers.
The fact is, dear colleagues, that the adversaries of our national health system in Spain represent the same social forces in the U.S. opposing the fundamental reform that your organization advocates, single payer.
We in Spain are struggling to protect a national health system, while you are struggling to establish one. We both are fighting hard in the belief that citizen involvement is vital to success.
A public health care system is efficient and cheaper to run. It gives health professionals and patients a better life and removes the worries of economic problems in the event of illness. It makes a major contribution to social and individual happiness.
We can be confident in the prospects for our success, because all sensible ideas that are fair and beneficial to the vast majority of the people eventually end up winning.
You have a long road before you, but we wish you every success as a sister organization. We extend our best wishes to all of our professional colleagues in your country and to the American people, the main protagonists and ultimate beneficiaries of your goal.
Health!
Federation of Associations for the Defense of Public Health
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The Federation of Associations for the Defense of Public Health hosted the annual session of the International Association of Health Policy in conjunction with its own meeting this September in Madrid and Toledo, Spain. FADSP invited Physicians for a National Health Program to the meeting to participate in a discussion of how physician advocacy can intervene in our time of global crisis. In the past FADSP has participated in PNHP events. We look forward to continuing this vital dialogue within our common struggle. We have so much to learn from years of effective advocacy by FADSP.
Thank you, FADSP, for the indispensable insight and essential confidence expressed in this wonderful letter of solidarity. Together we shall overcome! ~ Andy Coates