Spain: World Cup Champs And A Health Care Success Story
August 11th, 2010
by
Chris Fleming
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The August issue of Health Affairs is titled “Lessons From Around The World.” One of the countries examined is Spain.
In her editor’s note, Health Affairs Editor-in-Chief Susan Dentzer writes that Spain
emerged from the Franco dictatorship in 1975 socially and economically behind much of the rest of Europe. But the demise of the old order cleared the deck for sweeping changes in health care, along with much else. Planners concentrated on building an infrastructure focused on primary care. A key goal was that no citizen in this nation roughly the size of Texas—and with a population today of forty-one million—was to be more than fifteen minutes away from a primary care site.
The results have been impressive, say Brown University’s Jeffrey Borkan and coauthors in “Renewing Primary Care: Lessons Learned From The Spanish Health Care System.” In 2007 Spain spent $2,671 per person, or 8.5 percent of gross domestic product (GDP), on health care; this was below the average of 8.9 percent for the industrialized democracies of the Organization for Economic Cooperation and Development, and well below the $7,290, or 16 percent of GDP, spent by the United States. Spain ranked sixth among thirty OECD countries in life expectancy after birth in 2007, compared to the U.S. rank of twenty-fourth, and 17th out of 224 nations in infant mortality in 2009, compared to the U.S. rank of 45th.
In their concluding paragraph, Borkan and his colleagues offer some good news, and perhaps some bad news, for the United States. The good news: “The Spanish experience has shown that it is possible to transform primary care, as part of an overall health care transformation conducted in a short time frame with modest investments, and still achieve impressive improvement in the health of the population.”
The bad news? “The Spanish example points out the critical nature of sustained, bipartisan leadership and commitment toward health care transformation.” (emphasis added)
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