O Memorando de Entendimento estabelece, na sua última revisão a 01 de Setembro de 2011 o seguinte:
.” First Update – 1 September 2011
3.51. Review and increase overall NHS moderating fees (taxas moderadoras) through:
i. a substantial revision of existing exemption categories, including stricter means-testing in cooperation with Minister of Social Security; [by September-2011] ii. increase of moderating fees in certain services while ensuring that primary care moderating fees are lower than those for outpatient specialist care visits and lower than emergency visits; [by September-2011] iii. legislate automatic indexation to inflation of NHS moderating fees. [Q4-2011]”.
A desejável reavaliação do regime de isenções conjugada com a adopção de medidas que melhorem a eficácia da cobrança, por parte quem as deve pagar, não deverá ser confundida com a transmutação deste instrumento, moderador da utilização inapropriada para um (ainda que discreto) co-pagamento emergente que venha a constituir-se numa efectiva barreira económica ao acesso.
A este propósito recomendamos uma breve leitura inspiradora retirada do relatório da OMS publicado no final de 2010: .” Equity, social determinants and public health programmes / editors Erik Blas and Anand Sivasankara Kurup”.
.”Health equity is a moral position as well as a logically-derived principle, and there are both political proponents and opponents of its underlying values. The Commission clearly acknowledges the values base of equity in the following definition: “Where systematic differences in health are judged to be avoidable by reasonable action they are, quite simply, unfair. It is this that we label health inequity” (1 ). While expecting opposition to the health equity position, it is important to note that most individuals and societies, irrespective of their philosophical and ideological stance, have limits as to how much unfairness is acceptable. These limits may change over time and with circumstances (4 ). To support the equity position in the public policy dialogue it will therefore be crucial to firmly document the extent of health inequities and demonstrate that they are avoidable, in that there are plausible interventions”.