Erich Fromm pays health tariff

Fromm therefore took the only €10 note that he had in his wallet and paid up. He was admitted to triage and given a green wrist tag. He then returned to the waiting room and waited.

Fromm actually died many years ago, but if he was alive now perhaps he’d have used the time in that waiting room to ponder a new paper - one on the current crisis in Europe? Or perhaps he would have wondered at the “notice to all patients” sellotaped to the wall.

“Non-payment of the legally stipulated tariffs within 10 days of notification warrants an increase of five times the initial rate – never less than €100”.

Even a champion of the dynamics of modern society like Fromm would be surprised!

But there’s an explanation. It was a measure taken up by the former Socialist government, as part of their state budget for 2011 (número 3 do artigo 158 da Lei 55-A/2010) – and it has been in force since last January.

Of course, today we all know it to be an(other) absurdity. Pedro Lopes, president of the Portuguese association of hospital administrators, admitted to «Público» newspaper only a few days ago that the large majority of hospitals weren’t applying these fines because they simply “didn’t have the means to collect them”…

There are even some administrators who consider the measure “useless and one that would effectively increase expenses” if taken on board.

But Erich Fromm’s surprise wouldn’t end here. Health service tariffs were introduced in the era of Prime Minister Cavaco Silva, in 1992 – a time when the country also faced difficulties. The idea was to ease costs born by the national health service – and help stem the chronic problem faced by hospital casualty departments: the fact that there are always too many patients for doctors to cope with.

Nineteen years on and the benefits of tariffs are still being discussed – but no-one has thought to study whether (or how) they’ve impacted on the day-to-day running of hospitals and health centres. Were they truly only brought in to discourage public affluence?

What we do know is that in September, as a result of the deal with the Troika, the new government is preparing to alter rules over health service payments. From September onwards, only a small fraction of people will be exempt from paying tariffs: people on or below the national minimum wage.

The rest of the country, irrespective of whether they’re chronic patients, blood donors, expectant mothers or children, will no longer be eligible for free treatment on the national health service (as they are now). And so we wait to learn what those new tariffs will be…