Private insurers hike premiums or drop older clients, according to affected individuals
Testimonials reveal premium hikes and policy non-renewals for older people. Private insurers refer serious cases to the public system, according to the thread.
English · Original discussion in Spanish · Published
Private insurers hike premiums or drop older clients, according to affected individuals
Private insurance is not a right, but a business. And like any business, it operates with ruthless logic: if the client ceases to be profitable, they are discarded. This is what several participants in the debate claim, having experienced firsthand how their medical insurance became a burden when they needed it most. The pattern they describe: from a certain age, premiums rise without limit, conditions worsen, and in the worst cases, the insurer simply does not renew the policy. One case, detailed, describes how, after undergoing a very costly surgical procedure, the company sent the expiration notice on the last day of the deadline. The affected person did not open the mailbox in time. They were cancelled. Without mercy.
Risk as an excuse: the logic of insurance applied to health
The technical argument is impeccable: higher risk, higher premium. This is the basis of any insurance, from a car to a yacht. And a 40-meter yacht full of rust and 80 years old, continuing with the analogy, is very expensive to insure. Translated to the human body, the matter sounds more uncomfortable, but the mechanics are the same. Insurers calculate probabilities, and the likelihood of needing expensive treatments skyrockets with age. From the age of 50, increases become 'brutal,' according to several testimonies. From the age of 70, it directly becomes a problem of adverse selection: the insurer wants clients who pay and do not use.
Some argue that this is common sense. If you have paid 60 euros a month all your life and at 70 expect them to cover weekly oncological treatments, the business does not add up. The conclusion, in that line, is that older people end up being 'meat for public healthcare' until they die. And that private insurance in Spain is 'insurance for the healthy.'
What happens when the policy becomes a trap?
The problem is not just the price. It is the renewal trap. Policies are renewed automatically, but the insurer reserves the right not to renew. And here comes the detail that many discover late: once out, getting back in is almost impossible. Companies require medical history, and with a history of expensive surgeries or chronic diseases, the door closes. Only a few lucky ones find an offer 'without looking at medical history,' which is usually the exception that proves the rule.
The result is a kind of health limbo: you pay all your life, but when the risk materializes, you are left without coverage. And then you have to return to the public system, which is precisely what you wanted to avoid. The paradox is cruel: private insurance covers you while you do not truly need it.
Private insurance does not save you from public healthcare: it refers you to it
Another myth that falls is that of total independence. In Spain, no private insurance allows you to completely do without public healthcare. Certain treatments and operations are exclusive to the public system, or simply are not in the insurers' medical charts due to their cost. For complex cancers, HIV treatments, and other serious conditions, private insurance refers to the public system. The difference is that, if you have a mutual fund for civil servants or military personnel, the mutual fund pays the bill. If you have a standard private insurance, they refer you and that's it.
The business, therefore, is limited to what is profitable: consultations, diagnostic tests, minor surgeries. The expensive is outsourced to the taxpayer. And meanwhile, private waiting lists also grow. With public healthcare saturated, more people take out insurance, and private insurance begins to be unable to cope. Some speak of waits of up to four months in the cheapest insurers.
The underlying debate: public or private?
The discussion inevitably leads to the eternal conflict between public and private management. Some argue that the public system is inefficient by definition, with untouchable officials and impossible appointments. Others recall that the public system is the only one that guarantees attention to those who cannot pay, and that private insurance only works if there is a public system behind it that absorbs what is not profitable. The most repeated conclusion is that neither is free: one is paid with taxes, the other with premiums. The difference is that private insurance can kick you out when you cease to interest them.
The future does not look good for older people who trusted their insurance. With the aging of the population, premiums will continue to rise and conditions to harden. The most reasonable prediction is that private healthcare will become a luxury for healthy young people, while older people return to depending on a public system under increasing tension. Unless someone invents a model that does not punish old age. For now, it does not seem that anyone is trying.
Private insurance is not a right, but a business. And like any business, it operates with ruthless logic: if the client ceases to be profitable, they are discarded. This is what several participants in the debate claim, having experienced firsthand how their medical insurance became a burden when they needed it most. The pattern they describe: from a certain age, premiums rise without limit, conditions worsen, and in the worst cases, the insurer simply does not renew the policy. One case, detailed, describes how, after undergoing a very costly surgical procedure, the company sent the expiration notice on the last day of the deadline. The affected person did not open the mailbox in time. They were cancelled. Without mercy.
Risk as an excuse: the logic of insurance applied to health
The technical argument is impeccable: higher risk, higher premium. This is the basis of any insurance, from a car to a yacht. And a 40-meter yacht full of rust and 80 years old, continuing with the analogy, is very expensive to insure. Translated to the human body, the matter sounds more uncomfortable, but the mechanics are the same. Insurers calculate probabilities, and the likelihood of needing expensive treatments skyrockets with age. From the age of 50, increases become 'brutal,' according to several testimonies. From the age of 70, it directly becomes a problem of adverse selection: the insurer wants clients who pay and do not use.
Some argue that this is common sense. If you have paid 60 euros a month all your life and at 70 expect them to cover weekly oncological treatments, the business does not add up. The conclusion, in that line, is that older people end up being 'meat for public healthcare' until they die. And that private insurance in Spain is 'insurance for the healthy.'
What happens when the policy becomes a trap?
The problem is not just the price. It is the renewal trap. Policies are renewed automatically, but the insurer reserves the right not to renew. And here comes the detail that many discover late: once out, getting back in is almost impossible. Companies require medical history, and with a history of expensive surgeries or chronic diseases, the door closes. Only a few lucky ones find an offer 'without looking at medical history,' which is usually the exception that proves the rule.
The result is a kind of health limbo: you pay all your life, but when the risk materializes, you are left without coverage. And then you have to return to the public system, which is precisely what you wanted to avoid. The paradox is cruel: private insurance covers you while you do not truly need it.
Private insurance does not save you from public healthcare: it refers you to it
Another myth that falls is that of total independence. In Spain, no private insurance allows you to completely do without public healthcare. Certain treatments and operations are exclusive to the public system, or simply are not in the insurers' medical charts due to their cost. For complex cancers, HIV treatments, and other serious conditions, private insurance refers to the public system. The difference is that, if you have a mutual fund for civil servants or military personnel, the mutual fund pays the bill. If you have a standard private insurance, they refer you and that's it.
The business, therefore, is limited to what is profitable: consultations, diagnostic tests, minor surgeries. The expensive is outsourced to the taxpayer. And meanwhile, private waiting lists also grow. With public healthcare saturated, more people take out insurance, and private insurance begins to be unable to cope. Some speak of waits of up to four months in the cheapest insurers.
The underlying debate: public or private?
The discussion inevitably leads to the eternal conflict between public and private management. Some argue that the public system is inefficient by definition, with untouchable officials and impossible appointments. Others recall that the public system is the only one that guarantees attention to those who cannot pay, and that private insurance only works if there is a public system behind it that absorbs what is not profitable. The most repeated conclusion is that neither is free: one is paid with taxes, the other with premiums. The difference is that private insurance can kick you out when you cease to interest them.
The future does not look good for older people who trusted their insurance. With the aging of the population, premiums will continue to rise and conditions to harden. The most reasonable prediction is that private healthcare will become a luxury for healthy young people, while older people return to depending on a public system under increasing tension. Unless someone invents a model that does not punish old age. For now, it does not seem that anyone is trying.
Summary of a discussion on Burbuja.info - Foro de economía, actualidad y política., translated from Spanish and reviewed before publication. Read the full discussion (166 replies).
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