# Spanish Healthcare system



## timr (Feb 1, 2010)

Hi, I hope this may be on interest to any pre-retirement age British residents here who currently have health care either through a "dummy" autonomo, private medical insurance or the Valenciano cuota scheme.

Briefly, a bill has been introduced into Congress (14/05/2010) which would require the Spanish Government to introduce a free and universal healthcare system for all residents (including foreigners) from the start of next year. The bill explicitly removes the need to pay into the Social Security system as a condition of accessing the health services here. Although there is a long and complex story behind this, the key points were unanimously agreed by all main political parties (PP, PSOE, IU etc) back in September of last year, and the proposal received the support of the Government in April (although without a commitment to a firm timetable). The current bill restates what has already been agreed but with a timetable. _If the bill is approved_ , Spain will have a system virtually identical to the NHS from 01/01/2010. 

Here are some links to reports in the Spanish media which pretty much summarize the story to date;

The vote in Congress Sept 2009 asking the Govt to take whatever measures necessary to guarantee a universal and free healthcare system in Spain.

Agencia Europa Press - Salud | europapress.es : noticias e información de actualidad

A report on the Government response in April in which they agree but without specifying a timetable:

EL GOBIERNO VUELVE A ANUNCIAR LA LEGALIZACIÓN DE LA UNIVERSALIDAD DE LA ASISTENCIA SANITARIA PÚBLICA | Boletín Informativo de la Sanidad Pública

Finally a report on the binding motion in front of Congress on 10/05/2010 which would require the Govt to put the system in place on 01/01/2011.

EL GOBIERNO VUELVE A ANUNCIAR LA LEGALIZACIÓN DE LA UNIVERSALIDAD DE LA ASISTENCIA SANITARIA PÚBLICA | Boletín Informativo de la Sanidad Pública


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## Maddalena (Feb 6, 2010)

I have to say I find this incredible with the current state of the economy in the EU in general and Spain in particular...this type of program has not proven to be sustainable in virtually any country. On this forum itself, I have heard so many negative comments about your NHS. I can tell you that the "free" healthcare in Canada is, IMO, a disaster. Do you view this possibility as a good thing??


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## timr (Feb 1, 2010)

Maddalena said:


> I have to say I find this incredible with the current state of the economy in the EU in general and Spain in particular...this type of program has not proven to be sustainable in virtually any country. On this forum itself, I have heard so many negative comments about your NHS. I can tell you that the "free" healthcare in Canada is, IMO, a disaster. Do you view this possibility as a good thing??


Personally, yes. The estimated additional cost of the changes amounts to less than 0.25 of the total health care budget so financially it´s not as huge a commitment as it may at first seem. I agree that public healthcare systems both in the UK and Spain come in for some criticism but that doesn´t mean that people which to see them abolished.


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## Pesky Wesky (May 10, 2009)

Maddalena said:


> I have to say I find this incredible with the current state of the economy in the EU in general and Spain in particular...this type of program has not proven to be sustainable in virtually any country. On this forum itself, I have heard so many negative comments about your NHS. I can tell you that the "free" healthcare in Canada is, IMO, a disaster. Do you view this possibility as a good thing??


What do you mean by *your* NHS, Spanish or British??


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## VFR (Dec 23, 2009)

Maddalena said:


> I have to say I find this incredible with the current state of the economy in the EU in general and Spain in particular...this type of program has not proven to be sustainable in virtually any country. On this forum itself, I have heard so many negative comments about your NHS. I can tell you that the "free" healthcare in Canada is, IMO, a disaster. Do you view this possibility as a good thing??


Yes "I" do as health care, correctly delivered, at the right price for the tax payer, should be very cost effective & essential for a civilised country.
Of course it need to run with the consumer in mind & the bill payer, that being the case the piss takers should know that they will not last long under the system whether they be shirkers/workers/company's etc.


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## 90199 (Mar 21, 2010)

I already get free Spanish Health care and so does my wife. The Spanish health care here on the Island of El Hierro, is far far superior to the health care I once knew in Yorkshire, England.

The buildings are clean, waiting lists are shorter. The only slight problem is language difficulties for non Spanish speakers, but I have managed so far.

Free health care is a must, private health care for retired people is far too expensive.


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## 90199 (Mar 21, 2010)

Post duplicated, gremlins!!


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## gus-lopez (Jan 4, 2010)

Err, what about 'extranjeros titular sin recursos' ? I thought that already covered anyone who didn't pay in ?


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## xabiaxica (Jun 23, 2009)

gus-lopez said:


> Err, what about 'extranjeros titular sin recursos' ? I thought that already covered anyone who didn't pay in ?


I understand that it's means tested, and you have to have 'paid in' - so is still 'contribution based'

it doesn't help those who might have enough to live on otherwise, but not for private health insurance or a 'dummy company' in order pay the 240whatever a month

the new idea would be residence rather than contribution based - so all legal residents would benefit


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## Guest (May 26, 2010)

Did they say anything about those of us who are here on a student visa? I'm empadronada, but have been told that I have no right to healthcare.


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## xabiaxica (Jun 23, 2009)

halydia said:


> Did they say anything about those of us who are here on a student visa? I'm empadronada, but have been told that I have no right to healthcare.


afaik you currently don't - as I said, it's contribution based - & you won't have made any contributions!

IF this changes I imagine as a legal 'resident' you would be covered - if a student visa makes you 'legally resident'

by that I don't mean you are here legally or otherwise - but whether or not they decided that a student visa means you are a 'resident'

is that making any sense?:confused2:


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## Pesky Wesky (May 10, 2009)

Pesky Wesky said:


> What do you mean by *your* NHS, Spanish or British??


OK so it was evident to everyone that _*your*_ NHS meant British. I have very limited contact with the British NHS, and have much more contact with the _*Seguridad Social*_ here. It's been discussed many a time on the forum and my opinion and the general opinion of the forumers seems to be that the Spanish system works quite well. There are long waiting lists, there aren't enough doctors, and the bedside manner is definitely lacking, but when you need treatment they come up with the goods.


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## Guest (May 26, 2010)

xabiachica said:


> afaik you currently don't - as I said, it's contribution based - & you won't have made any contributions!
> 
> IF this changes I imagine as a legal 'resident' you would be covered - if a student visa makes you 'legally resident'
> 
> ...


Hey! - I did one job for the consejeria here in my comunidad autonoma - that makes me a contributer!  

And it doesn't make any sense  but that's not your fault. Just another fun Spanish experience! I should be a legal, contributing resident by the end of next year. I'll just wait it out. And with all that's going on, what with the cutting of funcionarios salaries, I DON'T want them to spend the money on giving folks like me healthcare.


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## Guest (May 26, 2010)

Pesky Wesky said:


> and the bedside manner is definitely lacking


But isn't that just typical Spanish straightforwardness?


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## Pesky Wesky (May 10, 2009)

halydia said:


> But isn't that just typical Spanish straightforwardness?


Having a national characteristic doesn't mean you should be able to get away with being down right rude and uncaring 

Any way it's like saying that the Brits are cold and reserved, many are, but many aren't!


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## xabiaxica (Jun 23, 2009)

halydia said:


> Hey! - I did one job for the consejeria here in my comunidad autonoma - that makes me a contributer!
> 
> And it doesn't make any sense  but that's not your fault. Just another fun Spanish experience! I should be a legal, contributing resident by the end of next year. I'll just wait it out. And with all that's going on, what with the cutting of funcionarios salaries, I DON'T want them to spend the money on giving folks like me healthcare.


with any luck, by the end of next year, it won't be contribution based


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## nigele2 (Dec 25, 2009)

xabiachica said:


> with any luck, by the end of next year, it won't be contribution based


Just two experiences:

My spanish wife went into hospital in Alcala near Madrid for a serious op. The differences I noted were:


My wife could see the waiting list on the web counting the numbers processed each day.
The op was a family event everyone there and informed throughout.
You could visit anytime and stay overnight.
You could buy and drink alcohol in the hospital and at the bedside.

The bedside care was great.

My spanish brother-in-law was diagnosed with cancer 5 weeks ago; he needs an urgent op. He met the surgeon and saw the anaesthetist soon after.


He has heard nothing in four and a half weeks. 
Whenever (everyday) the hospital are contacted staff are amazed and sympathise with the worry caused – but can offer no information of any kind.

The good and the bad like anywhere I guess


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## xabiaxica (Jun 23, 2009)

nigele2 said:


> You could buy and drink alcohol in the hospital and at the bedside.
> 
> The good and the bad like anywhere I guess


is that the good or the bad


sorry to hear about your BIL though


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## nicola rose (Feb 1, 2010)

it is intesting to read this. However, i cannot see this happening in Spain not only due to the economy the state its in, but no way, can i see the Spanish wanting to give free medical to foreigners as they dont like giving anything to anyone jejejeje. It will as a suprise if, this goes ahead. saludos


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## nigele2 (Dec 25, 2009)

nicola rose said:


> it is intesting to read this. However, i cannot see this happening in Spain not only due to the economy the state its in, but no way, can i see the Spanish wanting to give free medical to foreigners as they dont like giving anything to anyone jejejeje. It will as a suprise if, this goes ahead. saludos


I believe the amount relates to 0.25%. Of that there is a lot never collected. And there is the expense of trying to collect it. And the future reductions in funding which will make it not very attractive. Doubt it makes any difference.

They could charge more for the bedside beer to recoup the costs of course


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## Guest (May 26, 2010)

My OH has a chronic illness that she'd almost given up trying to get any help with in the UK. When she moved here she emailed a Spanish support group and got a response from one of the leading specialists in the condition in Europe (maybe even the World) amazingly he gave her his mobile phone number and email address. Fate would have it that he was based at Malaga Hospital at the time and sorted out an appointment within a week. Incredibly without any paperwork, no social security, no e111, nothing at all she was seen and given prescriptions, blood tests and a whole heap of advice on what to do. Fast forward 2 1/2 years and she's in remission, only visits the specialist once every 6 months and has never been healthier (relatively speaking)

Our experience of the health system has been 100% good - even the local doctors are great!


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## timr (Feb 1, 2010)

nigele2 said:


> I believe the amount relates to 0.25%. Of that there is a lot never collected. And there is the expense of trying to collect it. And the future reductions in funding which will make it not very attractive. Doubt it makes any difference.
> 
> They could charge more for the bedside beer to recoup the costs of course


Hi, completely agree. When you look at the groups of people excluded from the system either they´re probably not dependent on public healthcare (therefore not interested) or will get in anyway through one of the "loopholes" which have started to appear over last couple of years (lawyers, ex-automos). Costs of administrating the current extremely complex arrangment must be very high, so surely there will be some savings in introducing a much simpler system.


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## timr (Feb 1, 2010)

Hi, for the folks who are interested in these changes, here´s a link to an article on the front page of this mornings El País. The Government will introduce legislation in November to complete the universalization of health care. This has already been agreed with the PP as the first point in the "Pacto por La Sandidad". Whilst details of the legislation aren´t as yet public, the proposals agreed previously have always included foreign residents.

Miles de personas sin paraguas sanitario · ELPAÍS.com


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## Muddy (Jan 14, 2010)

Some additional interesting reading about this;

Health care in Spain is not universal

Also "Spain overturns Swedish and British proposal on expat health"
Spain overturns Swedish and British proposal on expat health
With this ruling it would appear on the face of it that the Spanish powers that be will be saving some money on health care costs!
With so many foreign residents in Spain this would seem fair!
What is also interesting is the end of the article on the 2nd link. "Andalucía region received 115 million € in 2009 for the attention of EU patients. The region issued bills totalling 28 million € last year for the treatment of tourists."
But what was the full cost so we can see how much extra it's costing them!
Would be helpful to see it all in a pie chart, I like them  

Sorry if this already been mentioned but I didn't find anything after a quick search!


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## timr (Feb 1, 2010)

Thanks for interesting links. The two development are almost entirely separate. The first one is a rewrite of the El Pais article which covers the introduction of a residency based system in Spain (or at least that what I think it means). Although no details have been released, previous proposals have included foreign residents . ie. it is not limited to Spanish Nationals. The second is about cross border health care or "health tourism" . Although they are separate issues, the introduction of a residency based system does have implications for cross-border health care. For example if Spain includes EU residents in the revised system, then the last thing Ms Jiménez wants to see is pre-retirement age Brits using their newly acquired health cards to seek treatment in back in UK and leaving her with the bill. 

If anyone is interested in finding out a bit more about the background to these developments, here´s link to a blog on the topic;

Health Care | Empty Deckchair


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