We can assure that sanitary care is the issue concerning the vast majority of the population, especially us, the elderlies. Several sociological studies corroborate that the elderlies give more importance to sanitary care than what they do to their economic resources. This is understandable if we take into account that within ageing we accumulate ailments, we become more fragile and, whether we want it or not, ageing is a very high risk for ailments and other maladies.
It has been confirmed that 80% of the elderlies have, at least one chronic disease, and 45% more than one. For instance, I have hypertension, cholesterol, and sugar and cardiovascular problems. Normally it is us, the elderlies, who go to medical consultations, generate more pharmacological expenses and are taken into sanitary care more often. Because of all this we are the ones who generate more sanitary expenses and, therefore, are seen as a burden and a threat for the Health System’s sustainability – a system that is normally short of economical resources. It is often though that the economic resources invested in our care don’t entail a social reimbursement if we take into account that we have already accomplished our mission in life.
There is no way we can accept this last statement. We are active elderlies, our knowledge and experience in life is necessary for our family and the rest of the society. One thing is retiring from active life, but social retirement is a different issue and there is a lot we can do and say on this area. Retirement simply entails a change of attitude; we are still able to enrich and make social and economical contributions to our country. If this wasn’t so, our presence here wouldn’t have any sense.
The fact that in Spain the Health and Sanitary System is managed by means of Public Administration and, in what has to do with medicines the elderlies enjoy a positive discrimination (for us the medicines are free whereas the rest has to pay a percentage of the original cost) does not mean that there is still a negative sanitary discrimination towards the elderlies. And as ageing increases more can this discrimination be noticed.
Nowadays in Spain, and I suppose it is the same in the rest of the Countries in the European Union, the percentage of population over 65 years old towards the population of children existing is higher, as can be seen on the following table:
YEAR
1960 (millions)
2004 (millions)
Total population
30.5
43.2
Children up to 15 years old
13.8 45,11%
6.1 14,16%
Over 65 years old
2.5 8,20%
7.3 17,87%
Our demography has changed, and is going to change even more because of the drop in the birth rate and the increase of life expectancy. A fact that carries us to the make the following question: are there enough geriatric specialists to take care of the elderly population existing?
The answer is clear and overwhelming: NO. The number of geriatric specialists in primary attention and specialised attention is zero. It has been estimated that the number of Geriatric Services among our hospitals comes up to a 15%. The number of qualified geriatricians in Spain comes up to about 800. There is only one professorship existing in the 27 Medicine Faculties. In the latest years between 45 and 50 vacancies for MIR (houseman doctors) have been announced; a low number taking into account the elderly population existing.
We can say that there is a lack of geriatricians among the different levels of our National Sanitary System, a lack of specialised training on Primary Attention and Specialised Care and few specialised units in the Public Hospitals. This is what we consider a discriminating fact towards the elderlies. The same problem existed in the 60’s regarding the infant population, but chairs, hospital services and training schools were created and the death rate among this area of the population decreased in a drastic way.
Another question we could make is: is there discrimination in pharmacological care?
If we consider what has been said previously, there is a positive discrimination meaning that medicines are given to us free, while active workers have to pay a percentage of the cost. Just lately the idea of the elderlies also paying a percentage for the medicines they get because they consume a higher amount is being constantly heard. This would show even more the negative discrimination suffered.
The simultaneous consumption of medicines belonging to different areas (cardiology, digestive organs, rheumatology, endocrinology, etc) can entail a negative reaction to the medicines taken. This fact constitutes a 10% of the admissions in hospitals, it is suffered by a 25% of the elderlies that are patients in our hospitals and represent a 35% of those who are treated in external medical consultations. These rates could decrease if the possibility of coordinating the elderlies’ treatments by means of a specialised geriatric system existed.
In addition, when talking about medicines, we could also consider the fact of the non-existence of patients over 65 years old in medical experiences as a fact of discrimination. This entails a lack of information when prescribing new medicines to elderly patients if we consider that this population is the one consuming a higher amount of them.
Therefore, because of the population’s ageing, pharmacological experiences should count with people over 65 years old among those participating and focus on reducing the patient’s suffering and increase their life expectancies with dignity.
Our Sanitary Systems should adjust to the demographic situation in each moment and, nowadays, the elderly population has a specific weight.
In my opinion it is important to take into account the advice issued in the Governing Board held by the European Union Doctors’ Committee that states that “the rights of the elderly population are the same of the rest of the citizens. They must have the same access to sanitary services without any restrictions.” The Spanish Constitution and the General Sanitary Law shelters this right from a legal and juridical base.
I World like to end my exposition with the following reflection: retirement must not bee seen as the final stage of our life but as a new stage entailing personal satisfactions and new social and economical possibilities. The increase of life expectancies and the development of the social welfare have made given us the opportunity of starring nowadays’ society. Therefore, we must not accept the fact of discrimination in any of the ways mentioned. We must work towards the eradication of any possibility of discrimination affecting the population our age.
We can’t forget we are part of a very important group because of the psychological strength given by our votes up to the point we could decide who to be in charge of the Government.
José Roberto López Martínez
Executive Vice-President
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