In 2017 the Spanish economy grew again above forecasts (3.1%), although two tenths less than in 2016; thus chaining three consecutive years above 3%. After the difficult decade that followed the outbreak of the economic crisis, the GDP figure for 2008 (1.163 billion euros) has finally been comfortably recovered. 

Within the framework of the euro area - which is so influential to us - GDP growth in 2017 was 2.3%. For 2018, the European Central Bank (ECB) has raised its growth forecast for the countries of the single currency to 2.4%. For Spain, the outlook is even more optimistic, with annual GDP growth forecast at 2.9%, 5 tenths higher than in the euro zone. 

The World Economic Forum identifies the main challenges Spain is facing: "Strengthening the sustainability of the fiscal system" for the medium and long term -including pension reform-; "developing a more efficient and effective public administration", "reducing existing over-regulation" and "promoting the digitalization and adoption of innovative technologies in the business sector". 

The institution also points to the strengths of the Welfare State: sixth in life expectancy and ninth in health services. 

If the objective is to guarantee the present and future needs of a population affected -as few in the Western world- by the inversion of the demographic pyramid and unemployment, within a framework of economic uncertainty; the dilemma between the growth of the State or the liberalization of services to citizens with strict institutional control, we believe has been overcome. At least as far as the protection of workers' health is concerned. 

The Mutual insurance companies collaborating with the Social Security contribute to the sustainability of the Social Security System through the agility that a public-private collaboration model allows. It is a model that has been in operation for many decades and has proved to be effective because it provides value for the worker, the company and, ultimately, for society. 

However, it should be noted that the economic model of the Mutual insurance companies collaborating with Social Security is countercyclical. In a scenario, like the current one, of rapid economic growth, economic benefits are growing exponentially.

The main cause is absenteeism, a critical factor that influences the evolution of expenditure, limiting the capacity to generate surpluses.

Despite this unfavorable environment, in 2017 Mutua Universal paid 56.66 million to Social Security corresponding to the surplus of 2016. In 2017, it achieved a positive result of 33 million, thus increasing our percentage share of the sector's contribution to the System, with full financial solvency. 

This contraction in our surpluses did not prevent us from continuing to address two other key chapters in 2017:

• A constant and growing investment, focused on two key aspects:
  • The increase in capacity and modernization of facilities to meet demand, as was the case in Valladolid, Huelva, Lugo, Pamplona and Seville.
  • The improvement of the quality of care and service, among which the Company Online Clinic (extension of the telemedicine system to the Health Surveillance Services of the associated companies), the implementation of virtual reality, the new Private Patient Area and the Universal Absenteeism Management model stand out.
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• Social aid. This chapter has reached an all-time high of almost 50% over the previous year. Last year a special package was launched for the self-employed and their families, which includes new financial aid related to the sustainability of the business and support for entrepreneurship.

 As you can see, we see no other scenario than to remain faithful to our commitment to workers, companies and society. In an inclusive and universal way. Mutua is Universal because it does not discriminate against sectors, geographical areas, companies or workers. In 2017, more than 42,000 protected workers joined our organization, the number of visits per professional contingency rose by almost 7% and those of common contingency by 15%. Always maintaining a demanding criterion in terms of efficiency and quality, as shown by the satisfaction survey, which in its overall calculation is around 8 out of 10. 

Innovation is in the DNA of Mutua Universal. We believe that the system of mutual insurance companies needs to reconcile responsible management and provision of services with creativity and the search for new solutions if we are to create a new virtuous circle with the present and, above all, the future in mind.

Insurance companies contribute to the sustainability of the Social Security System in terms of flexibility, which enables a model of collaboration between the public and private sector. It is a model that has been in practice for many decades and that has proved to be efficient by providing value for the employee, the company and above all for society.