L?evoluzione del sistema sanitario spagnolo

Since the early seventies up to the late eighties the total health expenses, as to the GDP (Gross domestic product), of the European Community countries increased then grew steady or decreased. In Spain, the public health expenses as to the GDP have notably increased, redoubling from the early sixties up to the end of the eighties. The Spanish health model comes from the Bismarck?s one, even if it was adopted sixty years later its establishment in Germany. Besides, it was only for not qualified industrial low-waged workers. Afterwards, in 1967, with the new law on Social Security we see a first attempt to universalise the National Health. The subsequent scheme provisions was directed towards an increase and rationalization of the system through integrating different structures and central and local competences. Since the beginning the Spanish National Health has been featured by a political and administrative decentralization where regions have maintained an important role. On the 25th of April 1986 the General law of health established two levels of welfare: the general practitioner and the specialistic assistance. The law provides that the doctor shall be free to choose in the primary assistance and it created an integrated network of public hospitals. Moreover, it recognized the right for a free practical of the medical profession, and of free enterprise in the sanitary sector. Finally, funding has been achieved through national and regional tax burden, and tickets have been introduced in order to control requests.