Spain has decentralized its publicly funded health care system. In the Catalonia region, public authorities have split the provision of health services from their financing, contracting with private sector providers for their delivery.
The principles that guide Spanish health care are similar to Canada’s, with two exceptions. They do not mandate a strict adherence to public ownership of facilities, and they include a focus that favours preventative medicine.
These principles also require a decentralized and distributed business-style management of publicly owned health institutions.
Although Catalonia requires co-payments for a variety of health services, citizens pay less out-of-pocket than Canadians do. It has fewer hospital beds and medical personnel.
Although public funding is national, provinces have autonomy in designing their local health care systems. Catalonia’s Ministry of Health funds the system and sets standards, while the Health Service monitors the performance of providers, the majority of whom are contracted. About 70% of facilities are privately owned.
The World Health Organization reports that an increasing number of countries contract for health service delivery, as an alternative to traditional publicly administered and publicly financed systems.
Catalonia’s health care system contains a strong emphasis on preventative public involvement through the promotion of healthier lifestyles.
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