Rise of Empires: Spain.

Chapter 588 Universal Medical Insurance
The Spanish royal family now possesses an astonishing amount of wealth, which has led to numerous Spanish conglomerates and companies executing strategies simply by Carlos devising a plan to speculate on property prices in the UK and the US.

If the British and American governments ignore the power of these conglomerates, they will soon find that housing prices in their major cities will rise rapidly in a short period of time, and even land around the cities will be snapped up.

In the short term, this may be good news for the economy, but in the long run, British and Americans will have to spend more money on property, and may even take on a lifetime of debt for a house they have lived in for decades, ruining their lives.

All of this has nothing to do with Carlos or Spain, and it doesn't even have much to do with Spanish capital.

After Spanish conglomerates and companies go to the UK and the US, they often collaborate with local corporate capital.

Firstly, it serves as a better disguise to avoid arousing the suspicion of the British and American governments. Secondly, it aims to attract more capital, expand property speculation to a wider scope, and thus more effectively drive up house prices in the UK and the US.

From the perspective of the British and American governments, even if Spain's property speculation succeeds, it will not have a significant impact on them.

On the contrary, the substantial economic growth resulting from rising house prices will make the performance of the British and American governments even more outstanding.

Spanish capital can also make huge profits through real estate speculation, and the only ones who may suffer are the people of Britain and the United States.

However, the harm caused by a sharp rise in housing prices will take a long time to manifest. Who will care about the opinions of the British and Americans years from now?

Although he devised a strategy to inflate housing prices, Carlo did not pay much attention to housing prices in the UK and the US.

After all, for Carlo, knowing that a global flu pandemic was about to break out, the most important thing was to take precautions against the flu and minimize the harm to the Spanish people from the flu.

After much deliberation, Carlos decided to implement widespread medical and employment insurance in Spain to protect the rights of Spanish citizens to medical care and employment.

Insurance is not unfamiliar to Spaniards and Europeans. Various countries have long had corresponding insurance systems, and some countries have even incorporated medical insurance into national policies, mandating that people pay premiums to ensure their medical needs are met.

Spain had previously implemented a health insurance policy, but it was more targeted at workers engaged in dangerous jobs and not widely applied to the general population.

While the Spanish government provides some subsidies for medical care for ordinary Spanish citizens, the amount is negligible, and in most cases, people still have to pay for it themselves.

If universal health insurance can be implemented nationwide, judging from the results achieved in health insurance for the working class, it should effectively alleviate the current medical problem facing Spain, namely the problem of people not being able to afford medical treatment.

Although Spain's per capita annual income is constantly increasing, in the face of serious illnesses, this meager income is ultimately a drop in the bucket.

Workers work hard all year, but if a family member falls seriously ill, all their earnings will be spent, and it may not even be enough.

In such circumstances, a medical insurance policy that provides effective protection is indeed a lifeline for workers and other people who urgently need money.

With this in mind, Carlo no longer hesitated and decided to implement comprehensive health insurance throughout Spain.

Given that the average annual income of Spaniards is not high, the annual premiums for insurance can be reduced, and the coverage amount can also be appropriately reduced, but reasonable compensation must be paid out, rather than excluding those who need insurance to save their lives.

This is something that must be fully regulated, and it is also a prerequisite for promoting universal health insurance. Carlo was well aware of human greed, and he also knew that without sufficient regulation, the development of health insurance would inevitably deviate from Carlo's expectations.

Ultimately, medical insurance is a policy designed to benefit the people. Its main purpose is to use a small amount of money from the majority of healthy individuals to provide life-saving funds for a small number of seriously ill people.

Regarding insurance claims, as long as there is no insurance fraud, neither public nor private insurance companies can refuse to pay out claims; this is Carlo's bottom line.

Of course, until universal healthcare is achieved, the regulation of insurance companies remains just talk. After all, there are currently not many large insurance companies in Spain, and most of them are funded by the government and the royal family.

The creditworthiness of insurance companies established by the government and the royal family is still guaranteed; at least they will not deliberately refuse customers who need insurance payouts for the sake of company revenue.

This is also the biggest difference between state capital and private capital; state capital does not prioritize money but rather national development.

After Carlos decided to promote universal health insurance in Spain, his first step was to conduct a public opinion survey, using related news reports to test the attitudes of the Spanish people.

As it turns out, public opinion surveys were indeed necessary. Currently, health insurance only enjoys some credibility among the working class, but it has not gained the trust of the larger Spanish population; many people are even completely unaware that health insurance exists.

At this point, it would be extremely difficult to quickly implement universal health insurance across Spain.

Most people are unwilling to lose a portion of their money each month in exchange for such medical insurance, since the monthly loss of insurance money is a real thing, and whether the insurance company will provide medical reimbursement in the future is a question mark.

It's not that people don't want to trust the government; it's just that this is something they've never encountered before, and given that it directly concerns their income, it's quite normal to have some doubts.

Let alone in this era, even in later generations, many people are unwilling to trust insurance. Of course, that's because the insurance industry in later generations has become so greedy, completely prioritizing income and ignoring the credibility of insurance companies.

Carlo didn't want Spanish insurance companies to be like those of later insurance companies, valuing revenue more than credit.

Putting aside other considerations, insurance companies established by the Spanish royal family must regard credit as the most important thing. To a certain extent, they can even accept losses.

After all, even if these royal insurance companies suffer losses, it might not necessarily be bad news for the royal family. The royal family doesn't lack money; what it lacks is the trust and support of the people.

If the annual financial losses of hundreds of millions of pesetas can be exchanged for the public's high level of trust and support for the monarchy, both Carlos and the future King of Spain would be willing to do so.

Seeing that the public still had some doubts about the so-called universal health insurance, Carlo was not in a hurry to immediately promote universal health insurance in Spain.

Of course, health insurance still needs to be piloted and promoted in select cities. This will allow more people to experience the benefits of health insurance. The pilot cities, needless to say, are primarily Spain's two largest cities, Barcelona and Madrid.

The reason these two cities were chosen as pilot cities for medical insurance is that they are the largest industrial cities in Spain, and a large number of workers have already been exposed to medical insurance.

On the other hand, the municipal governments of Madrid and Barcelona were also quite wealthy at this time due to the rapid development of industry and economy in the two cities.

This also means that the two municipalities can be a good help in promoting health insurance without significantly impacting the Spanish government's budget.

People living in large cities tend to have higher levels of education than those in smaller cities and rural areas. These individuals are more receptive to new things and less resistant to policies such as health insurance.

Several days had passed when the Spanish government announced Madrid and Barcelona as two pilot cities for universal health insurance.

The city governments of Madrid and Barcelona are constantly promoting the benefits of universal health insurance throughout the city and promising that the city government will endorse the credit of legitimate insurance companies.

In other words, if a citizen purchases insurance but the insurance company refuses to pay out, the municipal government will compensate the citizen for their loss.

The reason why the municipalities of Madrid and Barcelona dared to make such guarantees was actually because of the support of the Spanish government.

Before implementing universal health insurance, the Spanish government had already revised the vetting process for insurance companies and raised the credit requirements for them.

To establish a private insurance institution in Spain, the first step is asset verification, ensuring sufficient funds are available for payouts.

Secondly, all shareholders of private insurance institutions must have sufficient credit backing. They must either own multiple legally and compliantly operating companies or have sufficient assets as collateral; otherwise, they will not pass the review.

In short, the Spanish government at all levels will act as the ultimate guarantee for citizens purchasing health insurance. If a private insurance company is found to be maliciously refusing to pay claims, the Spanish government will forcibly compensate the insured citizens by confiscating the insurer's assets.

This may seem unfair to private insurance companies, but that's only in cases where they maliciously refuse to pay out.

If private insurance companies operate legally and compliantly, the Spanish government is unlikely to punish them. Of course, expecting these capitalists to strictly abide by the law is less realistic than hoping that all Spaniards are healthy and don't need health insurance.

The strict scrutiny and regulation of insurance institutions established by the Spanish government will serve as a last resort for the public when they encounter difficulties.

If the universal health insurance policy proves feasible, the Spanish government will continue to make improvements in the future, allowing businesses to bear a portion of the health insurance costs and reducing the public's expenditure on health insurance.

Of course, that's all in the future. In recent years, the Spanish government has already done quite well simply by achieving results in implementing universal healthcare.

It is no exaggeration to say that even a hundred years from now, many countries will still not have achieved significant results in the field of health insurance.

It can only be said that poverty is indeed the greatest suffering. As the ruler of Spain, all Carlo could do was to reduce the suffering of the Spanish people as much as possible, which was a way of being worthy of the crown he wore and the heavy responsibility he shouldered.

On January 15, 1917, a trial of universal health insurance was officially launched in Madrid and Barcelona.

The city government has notified all factories and businesses in the city that they must deduct a portion of their monthly salaries as medical insurance costs.

Because it's deducted monthly, this portion of the funds is relatively small. Furthermore, with the widespread implementation of universal health insurance, the mandatory health insurance coverage is at its lowest, and naturally, the reimbursement amount is also the lowest.

Under Spain's current universal health insurance system, residents of Madrid and Barcelona must pay 0.1 pesetas per month for health insurance, totaling 1.2 pesetas per year.

For a family of four, the annual increase in expenses is 4.8 pesetas, which is not a very large expense.

After all, a family of four with two working members would likely have a total annual income exceeding 1000 pesetas.

The cost of medical insurance is only one two-hundredth of the total annual income. For example, if a family in later generations has a total annual income of 5 yuan, they would pay about 250 yuan in insurance premiums, which is still within an acceptable range.

Medical insurance can be paid in multiple ways, including monthly payments, quarterly payments, and annual payments. The different payment methods mean different coverage periods; monthly payments only provide coverage for one month, while annual payments provide coverage for the entire year.

During the coverage period of medical insurance, people can request medical insurance to pay for any accidental injuries they encounter when seeking medical treatment, or request medical insurance reimbursement after seeking medical treatment.

Although each person only pays an insurance premium of 1.2 peseta per year, the insurance coverage that can be reimbursed per person per year is as high as 240 peseta, which is 200 times the insurance premium.

This low-investment, high-return health insurance, coupled with a series of activities organized by insurance companies to encourage more people to willingly pay premiums, finally led to fewer complaints from the people of Madrid and Barcelona about universal healthcare.

Of course, this also depends on Carlo's great prestige among the people.

Even if a different monarch were to implement universal healthcare, achieving this would not be easy. Even if the public understands that healthcare will provide them with immense protection, it doesn't mean they will willingly accept an additional annual healthcare expense.

Especially for people who are in good health, they are unwilling to pay such an insurance premium every year, since the probability of these people getting sick is extremely low.

Another issue is that the poorer population, who have worked hard to earn money, have to have a portion of it taken away as medical insurance fees, which they are unwilling to accept.

If Carlo hadn't stepped forward to appease the public, there would likely have been protests in Madrid and Barcelona against the government's forced implementation of universal healthcare.

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(End of this chapter)