Healthcare Systems & Social Security in Spain

• A health system encompasses the resources, institutions, and personnel dedicated to safeguarding the health of a population.
• The objective of a healthcare system is to prevent, diagnose, and treat illnesses, while also promoting health.
• Healthcare systems are financed through taxes, insurance, or private payments, varying by country.

Healthcare Models

• Different healthcare system models exist, varying in funding and management approaches.
• The Beveridge Model is funded by taxes and managed by the State, ensuring universal and free access (e.g., United Kingdom, Spain).
• The Bismarck Model is funded by social security contributions and managed by private entities under state supervision (e.g., Germany, France).
• The Liberal or Market Model is based on private insurance, without guaranteed universal access (e.g., U.S.).
• The Mixed Model combines aspects of the other models.

Social Security System in Spain

• The Social Security system protects citizens against situations like illness, unemployment, or retirement.
• It is funded by contributions from workers and employers.
• In healthcare, it covers free medical assistance for affiliates and beneficiaries.

Spanish Healthcare System

• The Spanish healthcare system is based on the Beveridge model, funded by taxes.
• It guarantees universal and free healthcare through the National Health System (SNS).
• The SNS is organized into different levels of care.

Healthcare Responsibilities

• Healthcare responsibilities are divided among different levels of government.
• The State coordinates, legislates, and regulates healthcare.
• Autonomous Communities manage healthcare assistance in their territories.
• City Councils are in charge of local public health, like controlling epidemics or sanitary inspections.

Healthcare Structure

• The healthcare structure consists of different health centers and services guaranteeing assistance to citizens.
• It's organized into Primary Care (health centers) and Specialized Care (hospitals and specialty centers).

General Organization of the Public Healthcare System

• The public healthcare system is structured as follows:
• The Ministry of Health directs and coordinates healthcare policy at the state level.
• Health Departments of the Autonomous Communities manage healthcare in each region.
• Health centers and hospitals provide direct healthcare assistance.

National Health System (SNS)

• The SNS is the group of public health services in Spain, characterized by:
• Public funding through taxes.
• Universal and free access.
• Decentralization in the Autonomous Communities.

Healthcare Services of the Autonomous Communities

• Each Autonomous Community manages its own Health Service, including hospitals, health centers, and other resources.
• Examples: SERMAS in Madrid and SAS in Andalusia.

Health Areas

• Health areas divide the territory into zones where healthcare resources are organized for efficient assistance.
• Each area has a reference hospital and health centers.

General Healthcare Coordination

• General Healthcare Coordination aims to ensure all levels of the health system work together, avoiding overlap and ensuring continuous care between Primary Care, Specialized Care, and Emergency services.

Alternative Forms of Healthcare Management

• There are different ways to manage healthcare.
• Direct management: The State manages health centers.
• Indirect management: Private companies manage public centers through contracts.
• Public health foundations: Non-profit institutions manage hospitals.
• Public health companies: Managed by the State but with a corporate structure.
• Health consortiums: Associations of public and private administrations.
• Administrative Concession: A public hospital is managed by a private company for a period of time.
• Healthcare agreement: Private services are contracted to supplement public healthcare.

Private Healthcare Sector

• The private healthcare sector complements the public system and is funded through private insurance or direct payment from patients.
• Includes clinics, private hospitals, and medical offices.

Professional Mutuals

• Professional Mutuals are private entities that manage healthcare for workers in case of work accidents or occupational diseases.

Private Health Insurance Companies

• Private Health Insurance Companies provide private health insurance, allowing access to private healthcare for a monthly premium.

Healthcare Services

• Healthcare Services are the services offered by the health system.
• Examples include: medical consultations, hospitalization, medications, healthcare transportation, and prosthetics.

Levels of Healthcare Assistance

• Healthcare is organized into different levels.
• Primary Care: The first point of contact, provided in health centers.
• Specialized Care: Includes hospitals and specialist consultations.

Primary and Specialized Care

• Primary Care involves prevention, diagnosis, and basic treatment.
• Specialized Care includes hospitals and specialists for more complex treatments.

Hospitals

• Hospitals are referral centers for specialized care.
• They are divided into general and specialized hospitals (pediatric, psychiatric, etc.).

Basic Regulations

• These are the main laws regulating healthcare in Spain:
• Law 14/1986, General Health Law establishes the organization of the healthcare system and guarantees universal healthcare.
• Law 16/2003, on Cohesion and Quality of the SNS regulates coordination between autonomous communities and defines the portfolio of services.
• Royal Legislative Decree 1/2015. Regulates healthcare assistance as a right of citizens.
• Law 33/2011, General Public Health promotes disease prevention and health promotion.
• Law 44/2003, on the Organization of Health Professions regulates the practice of health professions.
• Law 55/2003, Framework Statute of Statutory Personnel regulates working conditions of healthcare personnel.
• Organic Law 1/2004, on Comprehensive Protection Measures against Gender Violence includes healthcare measures for the protection of victims.
• Organic Law 3/2007 for Effective Equality between Women and Men promotes equality in the health and work fields.