Measure comes into force on January 1
A little pre-published decision taking away the right to free health care in Portugal of those who have left the country for the purposes of taxation is causing a major ruckus.
Representatives of Portuguese expat communities all over Europe complain principally of the “lack of information about the measure”.
Paulo Costa, founder of the “We are also Portuguese” movement, tells Lusa that in his view the situation is “extremely serious”. This is a decision that appears to have been taken “without a debate; without talking to people; without prior notice…”
“If this comes into force on January 1, without anyone being informed, we’re going to have very complicated cases of people coming here and expecting everything to work as usual,” since they are “Portuguese and have a patient number”.
What appears to be happening is that doctors in primary healthcare services have been informed that, as of January 1, Portuguese people with a tax address outside of the country are to be considered “inactive”.
This means that whenever they use a Portuguese SNS (national health service) service, they will have to pay the cost.
Nelson Magalhães, vice-president of USF-AN (the national association of family health units), told Lusa that the decision was conveyed to the units at a meeting held in October with officials from the Central Administration of the Health System (ACSS) and the Ministry of Health’s Shared Services (SPMS).
At issue is the application of order number 1668/2023 that “defines the organisational rules and management mechanisms relating to the National Patient Register, as well as the rules for registering citizens with the SNS and enrolling them in primary healthcare”.
A source from ACSS told Lusa that the order stipulates that enrolment in a Primary Health Care Unit presupposes active registration in the National Patient Register, which “has residence in Portugal as a mandatory condition”.
Until now, Portuguese residents abroad with a Portuguese SNS number paid the same charges as residents in Portugal when they accessed its services.
Now, they will have to bear the cost of all SNS services, “except in situations of death” – as in death the ‘foreign taxpayers’ reverts once again to being a Portuguese citizen, albeit deceased…
Citing the text of the order, Lusa concedes that “although there are no precise indications as to the method” by which emigrés should be informed of these changes, “primary healthcare professionals are trying to contact users” registered as living abroad “who react with apprehension and some anger”.
Paulo Costa is not in the least bit surprised. Says Lusa, he accuses the government of going ahead with a measure without prior consultation with the Council of Portuguese Communities (CCP), which should happen since it has repercussions for Portuguese citizens living abroad”.
He dubs the situation “yet another lack of understanding on the part of the government in relation to the communities and in contravention and non-compliance with what the CCP law says”.
Lusa has spoken with other emigrés who explain that they “still prefer to use the health service in Portugal” when they need to, as the “language and familiarity make it easier to get treatment”.
And then there is the whole aspect of ‘not wanting to cut links’ that people may have with a family doctor ‘back home’.
According to Nelson Magalhães, hundreds of emigrés are going to be affected by this new measure “since out of a universe of 1,750 users (per family doctor), around 100 have emigrated.
“The impact will also be felt on the income of doctors, who are paid according to the number of users on their lists (model B) and who, in order to maintain the same amount, will have to include more users and, above all, people who consume more services, which will make the medical response even more difficult”.
Another potential consequence could be a form of “separation of families” in the case of someone who has emigrated (generally for financial reasons), but who has left the rest of his/ her family behind, he said.
Source material: LUSA