# national health insurance



## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

how can i obtain the national health insurance in spain?
i am a resident but never worked so far here in spain...

thanks


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## jojo (Sep 20, 2007)

enjoylife said:


> how can i obtain the national health insurance in spain?
> i am a resident but never worked so far here in spain...
> 
> thanks


You have to pay into their social security system, either by getting contracted employment or by becoming autonomo/self employed. Otherwise its either private or pay as you go

Jo xxxx


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> how can i obtain the national health insurance in spain?
> i am a resident but never worked so far here in spain...
> 
> thanks


Hi 

whereabouts are you?

in most of Spain you either need to have a job with a contract where your NI is paid, or be registered as self-employed & pay that way

you say you're from austria - there might be a reciprocal agreement


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

thanks for the feedback......i live since many years in marbella
and have had so far a privat insurance,but now it s getting to expensive(the age)
working here?you probably know about the unemplyment we have specially in andalusia....
and also matter of age......


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## mrypg9 (Apr 26, 2008)

enjoylife said:


> thanks for the feedback......i live since many years in marbella
> and have had so far a privat insurance,but now it s getting to expensive(the age)
> working here?you probably know about the unemplyment we have specially in andalusia....
> and also matter of age......



If you are of the appropriate age you can under some circumstances apply to the UK NHS to be transferred to the Spanish health system, although that depends on your level of NI contributions (I think).


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## xabiaxica (Jun 23, 2009)

mrypg9 said:


> If you are of the appropriate age you can under some circumstances apply to the UK NHS to be transferred to the Spanish health system, although that depends on your level of NI contributions (I think).


the poster is from austria


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

lovely poster........
UK NHS ? i dont have a address in UK......
and also i am not in pension yet...

anyway thanks for your replies......have a good day


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> lovely poster........
> UK NHS ? i dont have a address in UK......
> and also i am not in pension yet...
> 
> anyway thanks for your replies......have a good day


are you austrian or british?

if british then when you get your UK pension you'll get free healthcare here

might be worth checking if austria do the same (if you're austrian) for when the time comes


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

xabiachica said:


> are you austrian or british?
> 
> if british then when you get your UK pension you'll get free healthcare here
> 
> might be worth checking if austria do the same (if you're austrian) for when the time comes


i am austrian....i have the information,if you live in uk(never mind if you are a foreigner or not) the first thing you get, free of charge is the national health insurance...the same applies for italy.....


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> i am austrian....i have the information,if you live in uk(never mind if you are a foreigner or not) the first thing you get, free of charge is the national health insurance...the same applies for italy.....


I think portugal too.......

but what I meant was - if you were a UK pensioner you'd get free healthcare in Spain - via an agreement between the govts.

maybe austria does the same


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## mrypg9 (Apr 26, 2008)

enjoylife said:


> i am austrian....i have the information,if you live in uk(never mind if you are a foreigner or not) the first thing you get, free of charge is the national health insurance...the same applies for italy.....


Your information regarding the UK and I suspect Italy is inaccurate.
If you are an EU citizen you will receive EMERGENCY treatment only. Just like Brits in Spain unless they qualify for Spanish state/regional cover.
In order to qualify for full free UK NHS cover you need to have paid into the system.
When non-EU citizens receive treatment on the NHS they get billed. Very often the bills are not paid, then tabloids like The Daily Mail go ballistic with stories of cheating foreigners etc.
It is a common and popular myth that foreigners can come to the UK and get all sorts of benefits. I've even been told that migrant Polish and Portuguese workers can get free cars and no-interest bank loans.
Some people get off on believing stuff like that.
There are enough British people abusing the benefit system without adding mythical foreigners to their numbers!!


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## Alcalaina (Aug 6, 2010)

In Andalucia wherever you come from you can get free healthcare if you are an _extranjero sin recursos _- i.e. your income is below a certain level - about €6000 a year I think. Make an appointment to see the social worker at your health centre if that applies to you.


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## gus-lopez (Jan 4, 2010)

mrypg9 said:


> In order to qualify for full free UK NHS cover you need to have paid into the system.


Unfortunately Mary that's not true. Payment of tax & / or national insurance in no way entitles you to NHS healthcare. That's stamped right across the top of NHS documents that were sent to my wife. The UK system, unfortunately , is residency based. You only have to live their to be entitled to complete free healthcare.

"Anyone who is deemed to be ordinarily resident in the UK is entitled to free NHS hospital treatment in England. “Ordinarily resident” is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled."

"Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence. The only thing relevant is whether you ordinarily live in the UK."


Eligibility for free hospital treatment under the NHS : Department of Health - Health care


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Unfortunately Mary that's not true. Payment of tax & / or national insurance in no way entitles you to NHS healthcare. That's stamped right across the top of NHS documents that were sent to my wife. The UK system, unfortunately , is residency based. You only have to live their to be entitled to complete free healthcare.

thanks Gus-lopez,

this is now very clear anyway i am not british and dont want to reside in UK........but a friend of mine she moved to UK and healthcare is free of charge even though she does not work or pay into the UK system.......

why spain is so different?i payed already a fortune for the privat insurance in 2decades.........


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Alcalaina said:


> In Andalucia wherever you come from you can get free healthcare if you are an _extranjero sin recursos _- i.e. your income is below a certain level - about €6000 a year I think. Make an appointment to see the social worker at your health centre if that applies to you.



thanks Alcalina for this information........:clap2:


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> thanks Alcalina for this information........:clap2:


and apparently it's free for everyone in cataluña


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## Sonrisa (Sep 2, 2010)

and Galicia.


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## mrypg9 (Apr 26, 2008)

gus-lopez said:


> Unfortunately Mary that's not true. Payment of tax & / or national insurance in no way entitles you to NHS healthcare. That's stamped right across the top of NHS documents that were sent to my wife. The UK system, unfortunately , is residency based. You only have to live their to be entitled to complete free healthcare.
> 
> "Anyone who is deemed to be ordinarily resident in the UK is entitled to free NHS hospital treatment in England. “Ordinarily resident” is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled."
> 
> ...


I should have qualified that by saying 'if a UK resident'.
Thanks for pointing that out, Gus.


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## stevelin (Apr 25, 2009)

I maybe wrong but I had a feeling that I ahd read somewhere that as from this january if you had been a resident and on Padron for more than 5 years you could get health care here. Not sure how you could find out though


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## xabiaxica (Jun 23, 2009)

stevelin said:


> I maybe wrong but I had a feeling that I ahd read somewhere that as from this january if you had been a resident and on Padron for more than 5 years you could get health care here. Not sure how you could find out though


there has certainly been talk along those lines for some time - but I hadn't heard that the law had been passed


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## timr (Feb 1, 2010)

Hi, here´s a link to the latest instalment in this long running story;

El Congreso aprueba una sanidad igual para todos - Público.es

Congress has agreed to complete the universalization of health care in Spain next year. The Bill has been passed to the Senate for approval. Although PSOE spokesperson says that foreign residents will be included, I´m a bit skeptical about that.

Tim


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## xabiaxica (Jun 23, 2009)

timr said:


> Hi, here´s a link to the latest instalment in this long running story;
> 
> El Congreso aprueba una sanidad igual para todos - Público.es
> 
> ...


I'm skeptical about that too - I don't see how the country can afford free healthcare across the board



> "todos los españoles y residentes legales en España tendrán derecho a la sanidad pública en igualdad de condiciones",


 Pilar Grande, socialist spokesperson

_"all Spanish citizens and legal residents in Spain will be entitled to public health on equal terms"_

we shall see what those equal terms are - in fact, isn't that already the case?

if you don't pay in, you don't take out - oversimplified maybe - but essentially true


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

El Congreso aprueba una sanidad igual para todos - Público.es

Thanks Timr for this link... very much appreciated


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## timr (Feb 1, 2010)

Hi, currently Spaniards and foreign residents are treated identically with respect to health care rights and, personally, I would like to see that continue. The cost of implementing the proposal is actually is not that great - 50-100 million euros. The point is that there are so few people excluded from the system that it seems to me to be neither fair nor, I would guess, cost effective to keep the current complex administrative machine in place. After all everyone who lives in Spain pays for the system since it funded from general taxation - the Social Security system has not contributed a euro since 1998. Since we all pay for it why should a small number of people continue to be excluded ? 

Tim


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## xabiaxica (Jun 23, 2009)

timr said:


> Hi, currently Spaniards and foreign residents are treated identically with respect to health care rights and, personally, I would like to see that continue. The cost of implementing the proposal is actually is not that great - 50-100 million euros. The point is that there are so few people excluded from the system that it seems to me to be neither fair nor, I would guess, cost effective to keep the current complex administrative machine in place. After all everyone who lives in Spain pays for the system since it funded from general taxation - the Social Security system has not contributed a euro since 1998. Since we all pay for it why should a small number of people continue to be excluded ?
> 
> Tim


I agree

but I bet there are many many people living here 'legally' - as in they are legally entitled to live here - that aren't on any lists, possibly because they can't see the point - who will suddenly become visible.............


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## agua642 (May 24, 2009)

Good topic! problem begins with 1 rule for 1& another rule for another.
Residency required for some EU countries but not for another.
TO much Red tape & it's getting worse in Spain.
Why don't all gov'n treat all humans as equals! We were put on this planet as equals.


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## Stravinsky (Aug 12, 2007)

agua642 said:


> Why don't all gov'n treat all humans as equals! We were put on this planet as equals.


I wish that were true, but unfortunately in reality ..... it's not


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

let s be positive and hope that it becomes reality.........
thanks for all the feedback.....


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

any news ??


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> any news ??


about???


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

must be the heat.......ha,ha

 about free national health care........do we all get it or not, in the coming year?any more news?


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> must be the heat.......ha,ha
> 
> about free national health care........do we all get it or not, in the coming year?any more news?


ahh

you won't have to ask


there'll be a BIG announcement!!!!


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## agua642 (May 24, 2009)

Yeah for sure it will b big national news !!


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Hasta mañana entonces........


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Hi all,

any n e w s ?


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## xabiaxica (Jun 23, 2009)

enjoylife said:


> Hi all,
> 
> any n e w s ?


well since we have a new government it's just as likely that _everyone_ will end up having to pay!!


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

yes,i am afraid this is it....
it sounded to good to be true.......


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## Stravinsky (Aug 12, 2007)

enjoylife said:


> yes,i am afraid this is it....
> it sounded to good to be true.......



Ive said so before, but my point got ignored.

I cant see any way that a government of a country in the mess that it is, is going to allow ex pats (of which there must be millions) free health care. It just doesnt make sense, when any government here is going to have to apply measures just the same as Greece did to get their economy right.

They would do miore good by sorting out the illegal property problems, land grab and the like, to make foreign buyers more confident about buying here 

Frankly, they should look after their own first. The majority of us have an alternative if it comes to the worst .... _they _dont


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## agua642 (May 24, 2009)

Stravinsky said:


> Ive said so before, but my point got ignored.
> 
> I cant see any way that a government of a country in the mess that it is, is going to allow ex pats (of which there must be millions) free health care. It just doesnt make sense, when any government here is going to have to apply measures just the same as Greece did to get their economy right.
> 
> ...


Frankly, they should look after their own first. The majority of us have an alternative if it comes to the worst .... they dont, Spain is in a real mess, but then so us all of Europe,medical should be free all around Europe, same rules should apply.....
the social Security payments in Spain are too high for everyone! to be able to afford. The Spanish have black money everywhere, only difference is they keep it within the family!! Strong family bonds.


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## xabiaxica (Jun 23, 2009)

Stravinsky said:


> Ive said so before, but my point got ignored.
> 
> I cant see any way that a government of a country in the mess that it is, is going to allow ex pats (of which there must be millions) free health care. It just doesnt make sense, when any government here is going to have to apply measures just the same as Greece did to get their economy right.
> 
> ...


I didn't ignore you - I've often said _fingers crossed but don't hold your breath_


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## Stravinsky (Aug 12, 2007)

xabiachica said:


> I didn't ignore you - I've often said _fingers crossed but don't hold your breath_


I wasnt talking about you


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## timr (Feb 1, 2010)

The last announcement from the previous government was that the universalization would be completed gradually with the remaining groups being brought into the system over course of the next year. First ex-autonomos with independent incomes at the turn of year, the lawyers (and other liberals professionals) next year... The whole point about this process is that according to Govt figures there are only around 200,000 people (including expats) excluded from the system. Although I´ve no idea what happens now, there has been cross-party support for this process for several years so in theory it should continue. Similarly, I´d hope and expect that it would be extended to those few thousand expats/ immigrants who don´t already have cover from other sources. Of course there are millions of foreigners living in Spain but the vast majority already have cover under existing laws so the additional cost should be minimal.


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## Pesky Wesky (May 10, 2009)

timr said:


> The last announcement from the previous government was that the universalization would be completed gradually with the remaining groups being brought into the system over course of the next year. First ex-autonomos with independent incomes at the turn of year, the lawyers (and other liberals professionals) next year... The whole point about this process is that according to Govt figures there are only around 200,000 people (including expats) excluded from the system. Although I´ve no idea what happens now, there has been cross-party support for this process for several years so in theory it should continue. Similarly, I´d hope and expect that it would be extended to those few thousand expats/ immigrants who don´t already have cover from other sources. Of course there are millions of foreigners living in Spain but the vast majority already have cover under existing laws so the additional cost should be minimal.


If they are closing down health centres and reducing timetables and staff numbers I would presume that an increase in the number of patients, no matter how small, is not on the agenda. Even less so with a PP government.


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## Alcalaina (Aug 6, 2010)

xabiachica said:


> well since we have a new government it's just as likely that _everyone_ will end up having to pay!!


Many a true word ...

La Generalitat bajará el sueldo de los funcionarios y estudia el copago - Público.es


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## xabiaxica (Jun 23, 2009)

Alcalaina said:


> Many a true word ...
> 
> La Generalitat bajará el sueldo de los funcionarios y estudia el copago - Público.es


Oh boy........


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

La Generalitat bajará el sueldo de los funcionarios y estudia el copago - Público.es

thanks for this info Alcalina...........


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

this is the newest article about healthcare

......http://www.actasanitaria.com/notici...la-tarjeta-sanitaria-europea-a-ciudadanos-com


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## agua642 (May 24, 2009)

Unfortunately there's nothing to display when clicking on the link:-(


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

España, emplazada a otorgar la Tarjeta Sanitaria Europea a ciudadanos comunitarios no español..........


http://www.actasanitaria.com/

please try again


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## gus-lopez (Jan 4, 2010)

Here's the article direct;

ACTA SANITARIA - Actualidad - España, emplazada a otorgar la Tarjeta Sanitaria Europea a ciudadanos comunitarios no españoles

Basically the EU has given Spain 2 months to reply / explain why they aren't giving free healthcare &/ or health cards , to non-retired , non-working foreigners in Andalucia & Valencia , as required by EU law.


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

something is moving now,i really hope it becomes reality soon


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## Stravinsky (Aug 12, 2007)

enjoylife said:


> something is moving now,i really hope it becomes reality soon


What is happening?
If you mean the previous article .... well ... the EU has been fining and chastising Spain over many years for things like the Valencia Land Grab, but soi far it seems to have done little good.

I still fail to see how a country that is in so much trouble can afford to increase it's burden by offering free health care to so many expats. It just doesnt seem credible at all ... sorry. We'll just wait and see I guess, but meanwhile people moving here and not working or are not over retirement age should budget for private health care.


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## jojo (Sep 20, 2007)

They need to get their whole SS system overhauled before worrying about us foreigners expecting free health care. Its not free, someone has to pay and the people paying taxes in Spain wont want that huge burden on top of everything else that they are going to be paying out for in the foreseeable future (in a severely in debt country). Sadly what would happen if they did try to bring this in, is that the service would become horrendously inefficient and probably not somewhere anyone would want to be treated, not to mention the outcry from the Spanish people who would probably resent the idea and the expats!!!

So not something I would wish for as things are right now

Jo xxx


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## Pesky Wesky (May 10, 2009)

jojo said:


> They need to get their whole SS system overhauled before worrying about us foreigners expecting free health care. Its not free, someone has to pay and the people paying taxes in Spain wont want that huge burden on top of everything else that they are going to be paying out for in the foreseeable future (in a severely in debt country). Sadly what would happen if they did try to bring this in, is that the service would become horrendously inefficient and probably not somewhere anyone would want to be treated, not to mention the outcry from the Spanish people who would probably resent the idea and the expats!!!
> 
> So not something I would wish for as things are right now
> 
> Jo xxx


I don't think now is the right time, but it seems that this comes from some time back, that this is implemented in other countries and it's to bring Spain, or more to the point Valencia and Andalucia, into line with the rest of Spain and the EU


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## jojo (Sep 20, 2007)

Pesky Wesky said:


> I don't think now is the right time, but it seems that this comes from some time back, that this is implemented in other countries and it's to bring Spain, or more to the point Valencia and Andalucia, into line with the rest of Spain and the EU


Yes, but I think we all agree now isnt a good time and I would assume that its been put on "the back burner" until the country is a little more financially secure. they've got enough to worry about! 

Jo xxx


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## Pesky Wesky (May 10, 2009)

jojo said:


> Yes, but I think we all agree now isnt a good time and I would assume that its been put on "the back burner" until the country is a little more financially secure. they've got enough to worry about!
> 
> Jo xxx


Yes, but what I mean is, if this is smth Spain agreed to in its day then the Eu may insist on their keeping the agreement. If it doesn't, it will incur regular fines. I know it may not be the wisest way to spend money just now, but this is what I understand the background to be.


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## jojo (Sep 20, 2007)

Pesky Wesky said:


> Yes, but what I mean is, if this is smth Spain agreed to in its day then the Eu may insist on their keeping the agreement. If it doesn't, it will incur regular fines. I know it may not be the wisest way to spend money just now, but this is what I understand the background to be.


Its this kind of thing that will cause the EU to self combust tho dont you think??? I always try to think further ahead. Imagine what Spains health service would be like if it is forced to put this rule into place while its in the mess its in?? They're already cutting back on staff and money. The health arena is always having to update and modernise at a cost, to then have to treat 1000s of extra patients many of whom are elderly so sadly need even more from a health service....

So yes its supposed to happen, taxes are supposed to be paid to fund it, but I'm not sure that it will happen in the foreseeable future, fines or not. A nice idea, but I hate to think how or the consequences.

Jo xxx


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## Alcalaina (Aug 6, 2010)

But wouldn't they claim back the costs from the immigrant's home country? That's what they do in Valencia isn't it?


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## Pesky Wesky (May 10, 2009)

Alcalaina said:


> But wouldn't they claim back the costs from the immigrant's home country? That's what they do in Valencia isn't it?


Probably, but just the cost of setting it up would be quite a lot I suspect. 
It might work out well for the PP actually 'cos they can claim to be looking after the immigrant


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## jojo (Sep 20, 2007)

Alcalaina said:


> But wouldn't they claim back the costs from the immigrant's home country? That's what they do in Valencia isn't it?


 Thats the theory and it works for those who are paying into the UK system or receiving pensions now because they have an existing NI number and can be tracked fairly easily, but those who dont..... this will obviously require more employees, more paperwork, more cost! The UK do it via passport numbers - or they did when I worked in the NHS and it was a glorious mess TBH, non EU residents were issued with bills and were never seen again - mind you, that was for minor treatments, not sure how it all worked for the more serious, long term issues. But one things for sure it doesnt work well, but it does mean EU citizens are, in the main treated. 

The original idea was (this was being talked about when I worked for them 5 years ago), not only to get treatment if we lived in or visited another EU country, but that we could all travel freely within the EU and get treatment in which ever country we so desired, thus reducing waiting lists in countries for particular procedures. ie, you could go to Spain cos they didnt have a very long waiting list for hip replacements. But the UK is having enough trouble even allowing people to travel to different health authorities/hospitals within Britain

Jo xxx


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## Stravinsky (Aug 12, 2007)

For those expecting free public health in Spain ...........

Yesterday a neighbour went to the doctor (La Font D'en Carros / Oliva area) to pick up his monthly supply of medicines which he has to take for a heart condition.

They didnt give him all of the medicines .... they left out the Statins.

On enquiring why, it seems that they have run out of money. Farmacias havent been paid since June.

The local Spanish say it is because they are more intent on doing the Formula 1 Grand Prix in Valencia and have spent a lot of money on it

Whataver, it seems that money is short enough to NOT give people with heart problems their full medicine requirements.

He went to the Farmacia and paid for them himself


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

They didnt give him all of the medicines......

i agree, this is really very sad .....thanks for sharing this info


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## mrypg9 (Apr 26, 2008)

On the positive side...I have an allergy involving sneezing, snuffling and sniffing and partial hearing loss in one ear -to what I'm allergic I don't know, it's probably genetic - and went to our local Ambulatorio. I saw a doctor after fifteen minutes of waiting and chatting to others waiting to see Dr. Vicious (that's how his name translates but he's very gentle).
It was decided I needed an XRay and an appointment was made immediately - I could have gone that afternoon but I put it off until next week as I'm not in pain.
I was given prescriptions for three different drugs...enough for forty days. Off to the adjacent pharmacy, another ten minute wait and another chat....and I got the drugs.
All free at the point of use.
It's not just the efficiency that pleases me....this will sound daft but it's actually quite a pleasant experience, visiting our village surgery. Nearly everyone Spanish in our village, the overwhelming majority of its small resident population, knows everyone else, and they include strange guiris in their lively conversation.
So different to the gloomy, silent ambience of our surgery in the UK.


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Modificación de la tarjeta sanitaria individual

news 9th of Jan.2012


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## agua642 (May 24, 2009)

Does this just apply to Castilla la Mancha?


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## snikpoh (Nov 19, 2007)

enjoylife said:


> Modificación de la tarjeta sanitaria individual
> 
> news 9th of Jan.2012



This has been discussed before and I still do not see what has changed!


It has always been the case that EU foreigners (us) should be treated exactly as Spanish Nationals are treated.

That is, what they can get, so can we.


What's new??


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## timr (Feb 1, 2010)

enjoylife said:


> Modificación de la tarjeta sanitaria individual
> 
> news 9th of Jan.2012


Hi, 
Towards the end of last year the Govt passed a law to complete the universalization of public health care (Ley 33/2011, de 4 de octubre, General de Salud Pública). The first step was the extension of the system to those unemployed people who had lost the entitlement. The Order from Castilla La Mancha just translates the requirement of the new national law into regional law. So something similar may well happen in all the regions since they will also have to implement the new national law.


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## xicoalc (Apr 20, 2010)

timr said:


> Hi,
> Towards the end of last year the Govt passed a law to complete the universalization of public health care (Ley 33/2011, de 4 de octubre, General de Salud Pública). The first step was the extension of the system to those unemployed people who had lost the entitlement. The Order from Castilla La Mancha just translates the requirement of the new national law into regional law. So something similar may well happen in all the regions since they will also have to implement the new national law.


Helathcare to ex workers is available in the Comunidad Vanenciana region even if you are not entitled to or not claiming unemployment benefit (you must have worked for a minimum of a year) and I agree that this should be the case but what worried me is if they extend free healthcare to all (like in the UK) ad the financial burden this will place upon an already struggling system.

I think that if you come here and work and settle and then find yourself without work after contributing for a period of time then indeed you should not loose the right to healthcare but having seen my mother in law refused treatment and tests because there is no money to pay for it, and having experienced the pharmacies striking because the regional government isn't paying them, and after being told myself I must wait at least a year for a camera to be put down my throat into my stomach, I really hope they don't just open up healthcare to any resident regardless of their contributions as this would spell disaster for the system and for the locals who are already feeling the pinch in their health service!


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Sorry about your mother in law .... Steve from Spain....



but your point
view is a little bit unfair to all the people they cannot find since years
a job or never had a job so far (5 mill unemployed) and
not everybody can afford a privat health insurance .........


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## xicoalc (Apr 20, 2010)

enjoylife said:


> Sorry about your mother in law .... Steve from Spain....
> 
> 
> 
> ...


Well it depends... take a spanish school leaver... can't get a job. They will get healthcare because they live with their family and are dependants of them. Couples... if one works the other is a dependant and gets healthcare (married or not), the problem comes for foreigners who come to the country, never work, or OH never works.. those are the ones who won't get healthcare.. and actually why should the government pay to care for people who have never contributed when they can't afford to care for their own or those of us who have paid in!


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## xicoalc (Apr 20, 2010)

steve_in_spain said:


> Well it depends... take a spanish school leaver... can't get a job. They will get healthcare because they live with their family and are dependants of them. Couples... if one works the other is a dependant and gets healthcare (married or not), the problem comes for foreigners who come to the country, never work, or OH never works.. those are the ones who won't get healthcare.. and actually why should the government pay to care for people who have never contributed when they can't afford to care for their own or those of us who have paid in!


I should add that obviously retired persons are different... or those who are using UK NI contributions to cover healthcare... my gripe is when people come across, don't work (and many know there is no work) and then can't pay for healthcare and expect it free... if you can't afford private, can't get a job then don't come!

Uff I am starting to sound like Mary!


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## Alcalaina (Aug 6, 2010)

Just a reminder that if your income falls below the minimum wage (€640 a month) and you already registered in the local health system, you can apply for free healthcare as a _persona sin recursos_. This applies to people from anywhere in the EU.


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## Alcalaina (Aug 6, 2010)

steve_in_spain said:


> I should add that obviously retired persons are different... or those who are using UK NI contributions to cover healthcare... my gripe is when people come across, don't work (and many know there is no work) and then can't pay for healthcare and expect it free... if you can't afford private, can't get a job then don't come!
> 
> Uff I am starting to sound like Mary!


Free healthcare in a civilised society should be a right, not a privilege. We don´t want Europe to end up like the USA do we!


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

I should add that obviously retired persons are different... or those who are using UK NI contributions to cover healthcare... my gripe is when people come across, don't work (and many know there is no work) and then can't pay for healthcare and expect it free... if you can't afford private, can't get a job then don't come!

!!!!!!!!!!!!!!!!
oh my godness.........very difficult to understand.....


by the way, I am living since 15 years in Spain and have a Privat Health 
insurance.....


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

Alcalaina said:


> Free healthcare in a civilised society should be a right, not a privilege. We don´t want Europe to end up like the USA do we!



this is the Way it has to be........


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## xicoalc (Apr 20, 2010)

Alcalaina said:


> Free healthcare in a civilised society should be a right, not a privilege. We don´t want Europe to end up like the USA do we!


So in your opinion people should have the right to come to Spain and demand free healthcare regardless of whether they have contributed or not? I think if the NHS took this "residency" based system away and based entitlements soley on nationality or contributions then it wouldn't be in half the state it is in.

Yes, healthcare should be a right to all Spaniards and all those who pay into the system (or retirees who have contributed or brought their entitlement from their homeland... but IMO if ever Spain goes to a residency based system and gives free healthcare to all it will spell disaster.

Completely agree, we don't want to be like the USA... but equally this country does not need, nor should it support "healthcare tourists" which i think would be the case if they base it on residency only!


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## xicoalc (Apr 20, 2010)

enjoylife said:


> I should add that obviously retired persons are different... or those who are using UK NI contributions to cover healthcare... my gripe is when people come across, don't work (and many know there is no work) and then can't pay for healthcare and expect it free... if you can't afford private, can't get a job then don't come!
> 
> !!!!!!!!!!!!!!!!
> oh my godness.........very difficult to understand.....
> ...


Not sure whats difficult about it! I also had private until the time I was paying into the system. I just have a real gripe for people (nobody here, just in general) who come to spain and expect free healthcare when they have paid nothing in... yes it's the EU and those who have paid enough in their own country should be able to get their country to pay here, but those who haven't shouldn't come and expect a free doctor, or a free anything for that matter±


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## timr (Feb 1, 2010)

steve_in_spain said:


> So in your opinion people should have the right to come to Spain and demand free healthcare regardless of whether they have contributed or not? I think if the NHS took this "residency" based system away and based entitlements soley on nationality or contributions then it wouldn't be in half the state it is in.
> 
> Yes, healthcare should be a right to all Spaniards and all those who pay into the system (or retirees who have contributed or brought their entitlement from their homeland... but IMO if ever Spain goes to a residency based system and gives free healthcare to all it will spell disaster.
> 
> Completely agree, we don't want to be like the USA... but equally this country does not need, nor should it support "healthcare tourists" which i think would be the case if they base it on residency only!


Steve, healthcare in Spain, like the UK, is funded from general taxation (IPRF, IVA etc) and not social security contributions. Since everybody who lives here pays these taxes and thereby contributes to the funding of health care system why should a small number of people be excluded from it ? 

Only about 200,000 people are currently excluded from the system. I can´t see how extending health care to an additional 0.5% of population will spell "disaster", particularly since many of those people will continue use other arrangements. The thing is Spain already has a virtually universal health care system in place whether you like it or not.

How on earth would a "health care _tourist_" would be eligible under a residency based system ? ??


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## xicoalc (Apr 20, 2010)

timr said:


> Steve, healthcare in Spain, like the UK, is funded from general taxation (IPRF, IVA etc) and not social security contributions. Since everybody who lives here pays these taxes and thereby contributes to the funding of health care system why should a small number of people be excluded from it ?
> 
> Only about 200,000 people are currently excluded from the system. I can´t see how extending health care to an additional 0.5% of population will spell "disaster", particularly since many of those people will continue use other arrangements. The thing is Spain already has a virtually universal health care system in place whether you like it or not.
> 
> How on earth would a "health care _tourist_" would be eligible under a residency based system ? ??


I would like to see where you get the figure of 200,000 people from. When you consider the sheer number of expats who are not entitled to healthcare (and not just brits but from all other countries). I think if you look at the real totals (including all the off radar people who would suddenly get registered with a doctor if they realised they could) it will be more. 

When i refer to healthcare tourism I refer more to people who move to a country in order to benefit from their healthcare .

A big chunk of the people who are foreign and get healthcare are funded by their own countries because of their contributions back home. Loads and loads of brits use their EHIC and "pretend to be on holiday" (although someone on here said recently that some areas are reluctant to accept them now as britain isn't paying up - don't know how true it is).

I still feel exactly the same that the "pay in or you get nothing out" culture in Spain is right and proper and if you look at the cutbacks being made already in healthcare (people who need tests being told theres no money and the scanner is out of service, people having a heart attach and having to travel up to 100km for the nearest 24 hour cardiac team, more and more drugs not being available on prescription etc) then I think that even "only 200,000" more people claiming healthcare, seeing a doctor, seeing specialists, having surgery, and having subsidised prescriptions is going to make a significant pressure on an already burdened health service.


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

timr said:


> Steve, healthcare in Spain, like the UK, is funded from general taxation (IPRF, IVA etc) and not social security contributions. Since everybody who lives here pays these taxes and thereby contributes to the funding of health care system why should a small number of people be excluded from it ?
> 
> Only about 200,000 people are currently excluded from the system. I can´t see how extending health care to an additional 0.5% of population will spell "disaster", particularly since many of those people will continue use other arrangements. The thing is Spain already has a virtually universal health care system in place whether you like it or not.
> 
> How on earth would a "health care _tourist_" would be eligible under a residency based system ? ??



Bravissimo.....thank you for this post......very true


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## snikpoh (Nov 19, 2007)

steve_in_spain said:


> Not sure whats difficult about it! I also had private until the time I was paying into the system. I just have a real gripe for people (nobody here, just in general) who come to spain and expect free healthcare when they have paid nothing in... yes it's the EU and those who have paid enough in their own country should be able to get their country to pay here, but those who haven't shouldn't come and expect a free doctor, or a free anything for that matter±


Part of the problem, and the stupidity of Spain, is that for some of us it is IMPOSSIBLE to pay into the system.

We are early retirees, we don't work - we have tried to make voluntary SS contributions but can not. We tried to go autonomo based on our rental income, but this was rejected by hacienda as an "invalid occupation".



For those of us who want to pay in, what can we do?


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## xicoalc (Apr 20, 2010)

snikpoh said:


> Part of the problem, and the stupidity of Spain, is that for some of us it is IMPOSSIBLE to pay into the system.
> 
> We are early retirees, we don't work - we have tried to make voluntary SS contributions but can not. We tried to go autonomo based on our rental income, but this was rejected by hacienda as an "invalid occupation".
> 
> ...


IN the valencia region there is (or was) an option to pay just for healthcare. It was similarly prices to a decent private policy but obviously better if you have pre existing conditions that perhaps private won't cover. I can't recall the price but it was about 200 or 250 a quarter i think! Hard to find info on it though i must admit, but I'm sure it is out there!


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## timr (Feb 1, 2010)

steve_in_spain said:


> I would like to see where you get the figure of 200,000 people from. When you consider the sheer number of expats who are not entitled to healthcare (and not just brits but from all other countries). I think if you look at the real totals (including all the off radar people who would suddenly get registered with a doctor if they realised they could) it will be more.
> 
> When i refer to healthcare tourism I refer more to people who move to a country in order to benefit from their healthcare .
> 
> ...


The 200,000 is a consensus figure. The Government in a report last year gave an estimate of between 90,000 and 180,000. The Health Care Commission gave a slightly higher figure (I believe). The Defensor del Pueblo said there were around 276,000. This includes foreign residents. 

As for your point about "pay in or you get nothing out", it is precisely those people who are paying in through taxes who are currently excluded since their incomes exceed the minimum to be eligible. They are excluded because they don´t pay into a system (the Social Security) which doesn´t fund health care or happen to live in the wrong part of the country. That´s crazy, isn´t it ?


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## xicoalc (Apr 20, 2010)

timr said:


> The 200,000 is a consensus figure. The Government in a report last year gave an estimate of between 90,000 and 180,000. The Health Care Commission gave a slightly higher figure (I believe). The Defensor del Pueblo said there were around 276,000. This includes foreign residents.
> 
> As for your point about "pay in or you get nothing out", it is precisely those people who are paying in through taxes who are currently excluded since their incomes exceed the minimum to be eligible. They are excluded because they don´t pay into a system (the Social Security) which doesn´t fund health care or happen to live in the wrong part of the country. That´s crazy, isn´t it ?


How can someone be working and paying taxes and not SS. If they are self employed they contribute into SS through their autonomo payments and if they are working (legally) and earning enough to pay tax then they or their employer will be making at least some SS contributions. Having any type of work contract gets you full healthcare, even part time, 5 hours a week on a temp basis!)


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## timr (Feb 1, 2010)

steve_in_spain said:


> How can someone be working and paying taxes and not SS. If they are self employed they contribute into SS through their autonomo payments and if they are working (legally) and earning enough to pay tax then they or their employer will be making at least some SS contributions. Having any type of work contract gets you full healthcare, even part time, 5 hours a week on a temp basis!)


It is possible to pay taxes without working. Additionally, one the main groups excluded from the the system at the moment are the "liberal professionals" (eg. lawyers). They work, are taxed on their income and expendiure, but are not required to set up an autonomo or pay into Social Security system. 

Why should people be excluded from the health care system on the basis that they don´t contribute to the SS when the SS has not paid euro towards the provision of health care in Spain since the last century. Doesn´t that seem a bit unfair to you ?


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## xicoalc (Apr 20, 2010)

timr said:


> It is possible to pay taxes without working. Additionally, one the main groups excluded from the the system at the moment are the "liberal professionals" (eg. lawyers). They work, are taxed on their income and expendiure, but are not required to set up an autonomo or pay into Social Security system.
> 
> Why should people be excluded from the health care system on the basis that they don´t contribute to the SS when the SS has not paid euro towards the provision of health care in Spain since the last century. Doesn´t that seem a bit unfair to you ?


I agree yes. If someone is paying tax but not SS (for example they rent out a house and contribute that way) then they of course should be entitled to get healthcare as they are contributing into the system. Sorry if i misunderstood you. 

My feelings are about people who pay nothing in ever... and then complain when they can't get healthcare... if you don't pay in in any way you shouldnt get out... but yes if you are paying taxes then of course this needs to be looked at IMO.

If someone is a lawyer one would imagine that they could afford a private policy especially if they are not paying the 250 a month autonomo! But, Spanish nationals should IMO always get healthcare... i say again, my gripe is with people who come to the country, pay nothing (be it tax or SS) and then expect healthcare!


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## timr (Feb 1, 2010)

steve_in_spain said:


> I agree yes. If someone is paying tax but not SS (for example they rent out a house and contribute that way) then they of course should be entitled to get healthcare as they are contributing into the system. Sorry if i misunderstood you.
> 
> My feelings are about people who pay nothing in ever... and then complain when they can't get healthcare... if you don't pay in in any way you shouldnt get out... but yes if you are paying taxes then of course this needs to be looked at IMO.
> 
> If someone is a lawyer one would imagine that they could afford a private policy especially if they are not paying the 250 a month autonomo! But, Spanish nationals should IMO always get healthcare... i say again, my gripe is with people who come to the country, pay nothing (be it tax or SS) and then expect healthcare!


It is just about impossible to live in a modern country like Spain or the UK and not pay taxes in some way. There has been a bit of shift over the last 30 years towards indirect taxation - IVA, Special taxes on fuel and tobacco etc. And of course the biggie for many foreigners in Spain has been the IVA or transfer tax on property purchase. That in itself is major contribution to the treasury.

So that just leaves us with people so poor that their tax contribution is minimal. I don´t want my health care improved by taking it away from some poor so and so who´s got beggar all anyway. Do you ?


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## xxxxxxxxxxxxxxxenjoylife (Jul 26, 2011)

How many people in the past and possible up to now
have no working contracts and therefore no social security....

years ago many Spaniards where taking advantage of
foreigners not to pay the social security ....
but if you wanted that job
you had to agree with it, you liked it or not.....and this happen still 3 
years ago to a friend


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## xicoalc (Apr 20, 2010)

enjoylife said:


> How many people in the past and possible up to now
> have no working contracts and therefore no social security....
> 
> years ago many Spaniards where taking advantage of
> ...


still happens, very much to and not just to foreigners!


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## Stravinsky (Aug 12, 2007)

timr said:


> It is just about impossible to live in a modern country like Spain or the UK and not pay taxes in some way. There has been a bit of shift over the last 30 years towards indirect taxation - IVA, Special taxes on fuel and tobacco etc. And of course the biggie for many foreigners in Spain has been the IVA or transfer tax on property purchase. That in itself is major contribution to the treasury.
> 
> So that just leaves us with people so poor that their tax contribution is minimal. I don´t want my health care improved by taking it away from some poor so and so who´s got beggar all anyway. Do you ?


I'm not poor and I dont pay direct taxes in the UK or Spain


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## Alcalaina (Aug 6, 2010)

snikpoh said:


> Part of the problem, and the stupidity of Spain, is that for some of us it is IMPOSSIBLE to pay into the system.
> 
> We are early retirees, we don't work - we have tried to make voluntary SS contributions but can not. We tried to go autonomo based on our rental income, but this was rejected by hacienda as an "invalid occupation".
> 
> For those of us who want to pay in, what can we do?


Go shopping!

IVA (VAT) is 18% on most things, food is 7%, petrol a lot more. We are all contributing into the Spanish economy, even if we don't pay direct taxes.


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## Alcalaina (Aug 6, 2010)

steve_in_spain said:


> So in your opinion people should have the right to come to Spain and demand free healthcare regardless of whether they have contributed or not? I think if the NHS took this "residency" based system away and based entitlements soley on nationality or contributions then it wouldn't be in half the state it is in.
> 
> Yes, healthcare should be a right to all Spaniards and all those who pay into the system (or retirees who have contributed or brought their entitlement from their homeland... but IMO if ever Spain goes to a residency based system and gives free healthcare to all it will spell disaster.
> 
> Completely agree, we don't want to be like the USA... but equally this country does not need, nor should it support "healthcare tourists" which i think would be the case if they base it on residency only!


Yes, I believe healthcare should be provided on the basis of need. Not residency, nationality, or whether you have or haven't "contributed" financially in one country or another. Just on the basis whether you are ill or not.

Incidentally Britain, which has provided healthcare based on that principle since the 1940s, has the most cost-effective service in the world.


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## xicoalc (Apr 20, 2010)

snikpoh said:


> Part of the problem, and the stupidity of Spain, is that for some of us it is IMPOSSIBLE to pay into the system.
> 
> We are early retirees, we don't work - we have tried to make voluntary SS contributions but can not. We tried to go autonomo based on our rental income, but this was rejected by hacienda as an "invalid occupation".
> 
> ...


Valencia Monthly Quota Scheme

check out this link how to pay for state healthcare in your region!


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