"Most countries in the European Union offer universal health coverage for their citizens. And when a citizen from one EU country travels to, or lives in another one, they also are covered. But now Spain is complaining" about the rule, "as more and more northern Europeans choose to retire along its Mediterranean coast." NPR likens the situation along Spain's Costa del Sol to that of Florida, where many U.S. seniors with costly health problems retire (Socolovsky, 1/19). SiMAP union, representing public health doctors in Spain, said non-Spanish EU nationals in Alicante, which has a large British expat community, account for 15-20 per cent of hospital admissions. Criticism is not directed at those who register their residency status and pay taxes, but at expats in the black economy who expect to get treatment by producing a European Health Insurance Card (Ehic), which is designed for the emergency care of holidaymakers. many thousands of Britons who regularly flip between homes in Britain and Iberia are also thought to arrange trips according to where they may get the best treatment, or jump waiting lists. Politicians have been concerned about healthcare "freeloaders" for several years, but Spanish doctors have been more muted. They have to decide what is "emergency" treatment and what isn't and, according to anecdotal reports, have tended to take the patient's word.
But Spain's health budget is as much under pressure as the NHS and the SiMAP move reflects fears among Spanish doctors of further belt-tightening. Cutbacks are bound to raise questions about the availability of resources for patients. The Spanish regions – which are autonomous in matters of health provision – have moved to prevent foreign nationals exploiting "free" healthcare. The last to take this step was Valencia. Two months ago, it introduced measures by which expatriates below retirement age and not registered as employed would no longer get free access.
They are now paying a €90 (£80) monthly tax, which will cease once they reach retirement age. The move brings Valencia into line with the rest of Spain – and France, where President Sarkozy took similar steps in 2007. But thousands of British men under 65 and women under 60 are still thought to be working unregistered in Valencia, the Costa del Sol and other expat