Find out what kind of medicine in Spain is paid or free: at what level is the Spanish healthcare system – reviews of Russians and other foreigners.
Medicine in Spain: paid or free – the Spanish healthcare system
Medicine in Spain is at the highest level and is recognized as one of the most advanced: according to WHO, the country ranks fourth in the world in terms of doctors' qualifications, clinic equipment and affordability. The Spaniards are the main centenarians of Europe, today the average life expectancy on the peninsula is 83 years, and, according to forecasts, the figure will grow.
Without diminishing the significance of the unique climate and the Mediterranean diet, the main merit in this belongs to a powerful health care system. 98% of the population has access to free health care, which is 2% higher than the European average, and there are 3.4 doctors for every thousand people (3.1 in other European countries). At the same time, the state provides not only outpatient treatment for citizens, but also surgery, hospitalization and rehabilitation, during which modern equipment and innovative developments are used for everyone, regardless of nationality or financial status. It is important that long-term academic training and a special approach of physicians make it possible not to eliminate the symptoms, but to detect the cause of the disease and prevent relapses. In our article, we will consider the features of the medical services of the Kingdom, which of them foreigners can use, and what to expect when communicating with local doctors.
How the healthcare system works in Spain: briefly about the main
The main principles of the sector are decentralization and accessibility. Funding for health care occurs mainly through taxes paid to the social insurance institution by employers. In addition, the vast majority of the population receives free medical care at the place of registration, regardless of status or nationality.
There are more than 800 private and public medical centers in the country, of which the largest number are concentrated in Catalonia (146 private and 66 public), Andalusia (64 and 47 respectively) and Madrid (49 and 33). Treatment of 80% of all diseases requiring a hospital falls on budgetary hospitals.
The procedure for contacting a doctor in a public and commercial clinic is different. The first involves the initial "filtering" of patients by the district general practitioner. After examining the patient, he gives recommendations in case of a slight ailment, prescribes medicines or directs him to the right specialist. Due to the high demand for Spanish medicine, the expectation of a visit stretches for weeks and even months, so some people prefer to go to private institutions where there is no queue problem.For a paid consultation, a person chooses a doctor himself, according to reviews on the Internet or recommendations from friends, he makes an appointment with him directly and saves time.
In both cases, when you visit a doctor, you will definitely be sent for testing: even if you have the results obtained at home, the Spaniards prefer to focus solely on their own examination when diagnosing. The cost of consultation and analysis depends on the category of the institution and the qualifications of the specialist, however, in any case, there is a strict control that excludes unnecessary therapeutic or diagnostic measures.
If we take into account the opinions of Russians about medicine in Spain, despite the overall satisfactory assessment, the medical approach is very different from what we are used to. The fact is that the country's medical workers piously observe the “Do no harm” principle, allowing the body to cope with the disease as independently as possible, therefore, unlike domestic practice, they are unlikely to prescribe a mountain of medicines unnecessarily. This does not mean that you will leave the office empty-handed – the treatment will be carried out, but strictly as directed and without the need to swallow pills "for prevention".
Another feature of medicine in Spain, unusual for Russians, is the nature of the relationship between the doctor and the patient, strictly formal and emphatically polite. An increased tone on both sides can lead to litigation and hefty fines. The physician also has the right to refuse to work with the client in case of systematic non-compliance with those prescriptions or parallel observation by another specialist. Among other things, foreigners are strongly advised to seek advice from a simultaneous interpreter company, especially in case of a serious illness: not all Spaniards are fluent in English, so it’s better not to risk your health due to “translation difficulties”.
Types of medical care
To briefly answer the question of what kind of medicine is in Spain, it should be noted that there are two types of services in the country: public, which the majority of the population has the right to use, and private, offered for payment or under an insurance policy.
Treatment in state-funded hospitals is absolutely free (with the exception of such areas as dentistry, aesthetics, cosmetology, etc.), so most Spaniards prefer to go there. Modern budgetary hospitals of the Kingdom are entire medical towns, with a huge staff of well-trained personnel, advanced laboratories, up-to-date equipment and the latest developments. Most work on the basis of universities, so the treatment process here is inextricably linked with scientific research and the introduction of new technologies.To take advantage of medical care, you need to get a kind of "patient passport" – a social insurance card, which is issued at the place of residence (upon presentation of registration).
The well-developed system of state-municipal health of Spain is complemented by the acquisition of the private sector. Today, the Spaniards serve 460 clinical centers that function due to capital from non-public sources. A considerable number of recent innovative developments and pilot projects was made precisely on their base. For example, unprecedented proton therapy in the fight against cancer is conducted under the auspices of Quironsalud Barcelona and Clinica Universidad de Navarra, and Madrid's Hospital Universitario Quironsalud is famous for its revolutionary diagnostic method with the help of artificial intelligence and conducting unique operations with a DA VINCI surgeon.
FREE STATE MEDICINE
The Spanish health system involves basic and emergency medical care of the population, including the entire range of services: consultations on various types of diseases, urgent ambulance and primary assistance, analyzes and operations (except dentistry).
The financing of medical institutions occurs at the expense of the federal and municipal budget, which allows them to have excellent equipment and maintain in high-class specialists. According to statistics, more than 600,000 professionals are working in the field of health, of which 200,000 are doctors of various profiles. Academic preparation here is the longest, it includes a mandatory five-year training at the university and the next 2-5 years of practice in the form of the intensity, intensive internships, training courses, participation in congresses, etc.
To understand, at what level is medicine in Spain, it is worth mentioning that the costs associated with the health system were represented in 2019 9.1% of the country's GDP. In each autonomous community, there is a minimum of one major budget hospital where you can seek urgent or planned help. According to the Royal Decoration of 2018, free medical services must be provided on a common basis not only to citizens and foreign residents, but also to illegallas. The only condition for addressing the doctor is the presence of a personal sanitary card (Tarjeta Sanitaria Individual), which includes a unique identification code and is issued in providing registration and social insurance numbers.
It is important to note that in practice, the implementation of the principle about accessibility and universality of health protection system is sometimes in question. In particular, gaining access to free medicine in Spain for aliens-illegal immigrants implies documentary confirmation of their stay in the kingdom of at least 3 months. The law no clear guidance on what kind of documents should be provided as evidence, therefore the decision is made on the ground, that is, the authorities of the autonomous communities.No need to say that the right of illegal migrants to medical care from the state, thus, strongly depends on the loyalty of local officials and their requirements.
Service for insurance
Despite the excellent quality of state-municipal care, more and more Spaniards and resident foreigners prefer to use the services of private institutions. It is no secret that, no matter how much medicine is available, such a private service is the cheapest pleasure: so, consultation in the Spanish clinic can do in 100-150 euros, the operation is from 1000. That is why most users of paid hospitals resort to the insurance policy, partially or fully covering the medical course. According to 2019, more than 20% of the population corrected health health.
The main players in the insurance market are five companies – ADESLAS, SANITAS, ASISA, DKV and MAPFRE, and they account for 70% of policies. Monthly quotas depend on the amount of coating, age and patient health, the standard price starts from 40 euros per month. In the struggle for customers, the agency are constantly competing among themselves in the proposal of benefits and discounts, for example, for individual entrepreneurs, colleagues, etc. The growth of the popularity of policies contributed to the solution of many enterprises to include their bonus package for workers. Due to this, the Spaniards along with the work contract receive a policy for themselves and significant discounts for family members.
It is practically unrealistic to arrange insurance with pensioners over 65 years old – it is assumed that the person at this age has a bouquet of "sore", and therefore will fly off the insured in a penny. Therefore, it is reasonable to insure in young age, then all possible chronic diseases will be automatically included.
Paid medicine
As noted, more and more Spaniards chooses the services of non-state medical institutions: over the past 25 years, the number of visitors to the paid clinics has grown from 7.2 to 20%. Today there are 460 hospitals funded by private funds in the country, many are known as leading innovative centers that approve and apply the most advanced developments and technologies. Among them – the prestigious Hospital Universitario La Zarzuela (Madrid), marked by Global Excellence Award, or the Medical Center Teknon (Barcelona), famous for its oncological department working on the model of Memorial Sloan Kettering Cancer Center in New York. In order to make sure at what place is private medicine in Spain, it is enough to look at the data of the budget expenditure part: 2.6% of GDP. This means that today the Solar Kingdom spends on this sector medical services by an average of 2.3% more than the other EU members, including such referents in terms of health care, like France or Germany.
The advantages of commercial-based treatment are numerous. If the expectation of the consultation of the public specialist takes weeks, and sometimes months, in a paid medical center this period is reduced by an average of up to 2 weeks.The same applies to operations, analyzes, check-up. It is also worth remembering that in public hospitals you will first have to go through the "filter" of a district doctor of general practice, which issues the direction to one or another department – bypass this scheme that can take a decent time, will not work.
Another difference is the level of comfort of the patient. Despite the fact that the highest quality of public health in Spain is not subject to doubt, private medicine in most cases means other attention of medical staff, more modern equipment and equipment. Unlike budget institutions, with hospitalization, the patient is provided by a separate comfortable chamber with an additional bed for the accompanying.
Meanwhile, clients with serious diseases with complications or chronic diseases requiring long-term therapy, the doctor of private centers is usually immediately redirected to colleagues in government agencies. It is explained simply: chronic cases require constant surveillance, which is more convenient to carry out within the centralized system, where there is a general practitioner leading the history of the patient.
Minus such treatment is an incomplete coverage of services provided for insurance. In some cases, for example, with serious operational interventions, the installation of expensive prostheses, etc., will have to pay the missing amount that is not included in the monthly quota.
Best Medical Institutions Spain
Consulting company Villafane Y Asociados, since 2000, the component of the reliability ratings of global firms, annually publishes a table of medical centers with the highest reputation – Monitor Empresarial de Reputacion Corporativa (Merco). The rating is based on factors such as advances in physicians, quality of services, management efficiency, as well as reviews of the workers, trade unions, analysts and patients. According to the last Ranking, published in 2019, the top ten of the best Spanish medical institutions headed Hospital Universitario La Paz de Madrid, known to the hematology departments, cardiovascular surgery, pediatrics and organ transplants. It follows Hospital Clinic in Barcelona, who was recognized as a specialized newsweek magazine the best in the country, and the ranking of Valencia and Seville institutions were noted in the ranking: