NIn a meeting with around 20 directors of Ribera Salud, the group’s CEO gave the order to refuse “unprofitable” patients in public hospitals managed by the consortium in Spain. The audio, released by “El País”, is crystal clear regarding the need to cut more expensive clinical procedures and lengthen waiting lists — “I am sure that they are capable of identifying which processes do not contribute to EBITDA”. With the scandal already in place, a document appeared from the Hospital de Torrejón — owned by the Regional Government of Madrid, but managed by the same group — listing the procedures used to limit activity and expenses: emergency rooms reconfigured to dispatch mild cases, transfers of complex patients to publicly managed hospitals, seriously ill patients accumulating hours of waiting until they give up. All those responsible who refused to violate the medical oath, which is to save lives, were fired. When management transforms a right into a product, the patient ceases to be a citizen. It becomes a cost. That is why it has never been indifferent whether the system is public or private.