Cablegate: Ambassador's Feb. 10 Meeting with Health Minister

DE RUEHMD #0175/01 0431611
R 121611Z FEB 10




E.O. 12958: N/A

MADRID 00000175 001.3 OF 002

Summary and Action Request
1. (U) In the Ambassador's February 10 introductory call,
Minister Jimenez outlined Spain's success in achieving
universal health coverage, a comprehensive eHealth system,
and progressive elder care. She noted that her Ministry was
working on a U.S.-EU MOU on eHealth that she would discuss in
her March 4 meeting with Secretary Sebelius. Separately, she
was committed to winning legislative approval for a law to
ban smoking in public places. At Ambassador's suggestion,
she may raise with Secretary Sebelius the issue of reducing
childhood obesity, and she is very interested in the First
Lady's childhood anti-obesity campaign. Post is reaching out
to the First Lady's staff to determine the possibility of a
briefing on the campaign and/or a FLOTUS meeting for the
Minister during her Washington visit. Post welcomes any
input or assistance addressees can provide. End Summary and
Action Request.

"Much to learn from each other"
2. (U) The Ambassador had an engaging and animated
introductory call on Spanish Minister of Health and Social
Policy Trinidad Jimenez on February 10. Minister Jimenez, a
career politician with little background in health care,
assumed the portfolio in April of 2009. She was quickly able
to use her experience as the former Foreign Ministry
Secretary of State for Latin American Affairs to reach out to
Latin American counterparts in the context of last year's
H1N1 epidemic. Her performance during the epidemic has
received generally high marks.

3. (U) Minister Jimenez was accompanied by her Chief of
Staff Jaume Segura, Director General for National Health
Service Pablo Rivero, and Deputy Director for International
Relations Carmen Castanon. The Ambassador was accompanied by
econoff. The Ambassador opened by stressing his interest in
health care and social policy issues. The Minister and the
Ambassador agreed that the U.S. and Spain had "much to learn
from each other" and "many possibilities to work together" in
the area of health and social policies. The Minister added
that she would meet with Department of Health and Human
Services (HHS) Secretary Sebelius on March 4 in Washington to
discuss bilateral and U.S.-EU issues, as Spain currently
holds the rotating EU presidency.

Spanish Successes: Health Care, eHealth, Elder Care
--------------------------------------------- ------
4. (U) Minister Jimenez said Spain's health care system
provides excellent universal coverage and costs only six
percent of the country's GDP. Still, she noted that the
current economic situation had generated a "small debate"
over the cost. Minister Jimenez attributed some of Spain's
health care success to a health information technology system
that provides 97 percent of Spanish physicians with access to
eHealth records and facilitated 150 million electronic
prescriptions last year. She responded to the Ambassador's
query on institutional barriers to eHealth by explaining that
barriers were minimized by having all stakeholders --
including physicians, academics, and the information
technology sector -- collaborate in developing the system.
The Minister pointed out that such collaboration also
bolstered the international market competitiveness of the
private firms involved in Spain's eHealth system.

5. (U) The Ambassador noted that the U.S. is expanding
eHealth and that the President's Strategy for American
Innovation includes over USD 19 billion in investments to
modernize eHealth. He suggested that the Ministry reach out
to Dr. David Blumenthal, the National Coordinator for Health
Information Technology at HHS. The Minister said she knew
Dr. Blumenthal and that her Ministry had been working with
his office on a U.S.-EU eHealth MOU that will be discussed at
her meeting with Secretary Sebelius. She also invited the
Ambassador to attend a conference of EU health ministers in
mid-March to promote eHealth.

6. (U) Minister Jimenez called elder care policy, which
comes under her Ministry, important for the "identity of the
government." She said that with an average pension of USD
1,000 per month, many of the elderly had to be cared for by
female relatives who had previously received no compensation.
In response, the Ministry began a program three years ago to
pay family care-givers for the elderly USD 500 per month: so
far the system, which is still being expanded, has 200,000
participants. Minister Jimenez added that the Ministry also

MADRID 00000175 002.3 OF 002

promoted programs encouraging an active elder life style by,
for example, subsidizing travel for the elderly (her parents
are taking advantage of the program to go to Bali). The
Ambassador complimented Spanish innovations in elder care
noting that it was a significant issue in the U.S. and in the
U.S. health reform discussion.

Spanish Challenges: Anti-Smoking Law, Childhood Obesity
--------------------------------------------- ----------
7. (SBU) Minister Jimenez said she was committed to getting
a law passed that would strengthen Spain's existing
anti-smoking legislation and outlaw smoking in indoor public
places, such as restaurants and bars. She said her
credibility was on the line if the law was not passed. She
described it as almost impossible to find a smoke-free
restaurant in Madrid, and bemoaned the risk second-hand smoke
created for non-smokers, especially children. Although the
relevant GOS bodies had largely agreed on the content of the
legislation, the Minister said she wanted to wait until the
right time -- likely in late summer -- to introduce the
legislation. She said the tobacco industry was using
restaurant and bar owners as surrogates to campaign against
the idea by arguing that it would reduce the number of their
patrons. The Ambassador noted that the same arguments were
heard in the U.S., but in some cases, anti-smoking laws
increased the number of restaurant and bar patrons. He said
he supported her effort.

8. (U) Minister Jimenez said she may also raise the issue
of reducing childhood obesity with Secretary Sebelius. The
Minister noted that Spanish children have the second highest
obesity rate in the EU. She said although the Spanish diet
is generally healthy, children are less physically active and
increasingly responsible for feeding themselves. The
Ambassador mentioned a pilot program in the U.S. that had a
significant impact by simply encouraging children to walk to
school. The Minister said she had hoped to introduce a
public campaign against childhood obesity, but budget
constraints made it likely the campaign would have to wait
until next year. The Minister added that she was very
interested in the just-announced campaign of First Lady
Michelle Obama against childhood obesity. She was interested
in the possibility of getting a briefing on the campaign
and/or meeting the First Lady to discuss the issue while she
is in Washington early next month. Post is reaching out to
the First Lady's staff to determine the possibility of a
briefing and/or a FLOTUS meeting for the Minister. Post
welcomes any input or assistance addressees can provide.

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