Spain's Health Care system

Last Wednesday my C1 students and me were listening in class to Cathy, a British GP talking about her job in the NHS, the largest publicly-funded health service in the world and, it is said, the fourth largest employer no less.

Then, as you all know, the Health Care reform is a controversial big issue for the Obama administration, in a country where private insurance has traditionally exerted a big influence.

How about our health system in Spain? Funnily enough, on April 25th 2011 it will be 25 years since the Spanish government presided by Felipe Gonzalez enacted the so-called "Ley General de Sanidad", which regulated the measures aimed at protecting our health as established in the 43rd article of the Spanish Constitution. The law created the "Sistema Nacional de Salud", which is the name given to the universal health assistance provided by the state and, later, its autonomous communities.

25 years later, recent surveys appear to find considerable dissatisfaction among Spaniards with the country's health care system and substantial support for reforms going beyond the government’s law in '86. To my mind, we can be relatively proud, compared to many other Western countries, of its success in achieving a more equal access to health care for its lowest-income citizens. Studies show that, although evidence of some barriers remains, low-income Spaniards are actually seeing doctors far more often than those of higher incomes, which might reflect their higher burden of illness but also their trust in medical services to provide certain other social services. Experts seem to suggest that these data are impressive, given the comparatively low level of per capita health expenditure and the percentage of gross national product which is invested in health care in our country (see video down below)

However, there's an increasing pressure on both the national and regional administrations to extend the availability of high-technology in medicine (specially in the prevention and treatment of cancer), as well as to reduce waiting lists and lengthen the time that health professionals spend with their patients. As Spain’s per capita income grows similar to that of the rest of Europe, so will the size of its middle and upper classes and, accordingly, a greater demand for better health care. The ever so ageing Spanish population is also a factor not to be sneezed at.

To cut this short, it seems evident that Spanish citizens have some expectations that are not, and will not, be easily satisfied by the efficiency of the current health system, however good it may be.

But what do you think? Are you satisfied with the medical assistance you're given by the state? If not, in what ways could our health service be improved? Perhaps you decided to go private and hire medical insurance? Does this work any better?

Hey, why not post your comments on this blog and exchange your views with your classmates?

Jeff Goldsmith is President of Health Futures, Inc. He is also Associate Professor of Public Health Sciences at the University of Virginia.