“Computers are useless. They can only give you answers.”
Pablo Picasso, born in Andalucia, artist in Catalonia.

Country’s healthcare system in a nutshell

38% of the European Union’s high speed rail track is in Spain (Eurostat, 2024). Spain’s high speed rail system has commonalities with its health care system. Both are decentralized but nationally integrated; efficient, fast, and cost-effective; focused on accessibility and equal opportunity.

Spain’s National Health System (SNS) is predominantly funded through general taxation, providing universal access to a wide range of services for all residents, including citizens, documented, and undocumented migrants (World Health Organization, 2023).

The Ministry of Health is responsible for national health planning and regulation. The 17 regional health authorities manage regional operational planning, resource allocation, and decisions regarding service provision. The SNS Interterritorial Council, which includes the national Minister of Health and the regional health ministers, coordinates high-level policies. Although there are minimal regional variations in coverage, there is variation in resource allocation.

Health services are delivered by a mix of public and private providers, with primary care doctors acting as gatekeepers to specialist and hospital care.

Each autonomous community, including Catalonia and Andalucia, has its own regional health authority responsible for managing and overseeing healthcare within its borders.

According to the most recent data from 2010, health insurance covered 99.2% of the population in Spain. This includes both those who are part of health insurance schemes and those who have free access to state-provided healthcare services (Our World in Data, n.p.).

Catalonia

The Generalitat de Catalonia governs Catalonia’s healthcare system. This autonomous government enjoys a high degree of independence in healthcare decision-making. The Generalitat sets policies, allocates budgets, and administers healthcare services to meet the specific needs of its population. Additionally, Catalonia has developed its own digital health platform, La Meva Salut, which provides citizens with a range of services to access and manage their healthcare information (Dedeu, 2017).

Andalucia

Similarly, in Andalucía, the Junta de Andalucía holds significant authority over the region’s healthcare system. The Junta is responsible for formulating healthcare policies, allocating budgets, and overseeing service provision within the region. Like Catalonia, Andalucía enjoys substantial independence in healthcare decision-making. The region has also developed its own digital health platform, ClicSalud+, which enables residents to access their health records and manage healthcare-related tasks online.

While both Catalonia and Andalucía have a high degree of autonomy in healthcare decision-making, the overarching framework of the Spanish healthcare system prioritises universal access and consistent standards. It ensures that residents across all regions receive a consistent level of quality care.

Public vs private

Open

Source: The World Bank.
The pink column refers to the public expenditure as a % of the country’s total healthcare expenditure. The blue dot is the country’s expenditure on health per capita, expressed in international dollars at purchasing power parity.

Bibliography

• Dedeu, 2017. Health System Catalonia. Presentation given by Dr Toni Dedeu, Director General, Government of Catalonia, Ministry of Health, 27 February. Available at: https://health.ec.europa.eu/system/files/2017-03/ev_20170227_co07_0.pdf (accessed 30 July 2024).

• Eurostat, 2024. Statistics Explained. Available at: Statistics Explained (accessed 20 January 2025).

• World Health Organization, 2023. Spain: Country Health Profile 2023. State of Health in the EU. Available at: Spain: Country Health Profile 2023 | European Observatory on Health Systems and Policies (accessed: 30 July 2024).

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