Public Comment

The Spanish Health Care Model

By Kelly Thompson
Thursday February 25, 2010 - 09:09:00 AM

I am a constituent registered to vote in Alameda County and am writing to express my strong support of real healthcare reform legislation that would minimally include a public healthcare option and ideally include a single-payer system that could exist alongside a reformed version of our current private healthcare system. 

I personally know the value of having affordable and adequate healthcare coverage after having worried about the possibility of needing to file for bankruptcy in California when my late husband was fighting lung cancer—and also witnessing my best friend and her husband recently go bankrupt in Texas because of his extremely expensive cancer treatments, which thank God saved his life. Currently, I am an active member of the Democrats Abroad Madrid Chapter, and my experience living in Spain, a country that has national healthcare for everyone (both citizens and noncitizens), has made me support healthcare reform back home in the United States even more strongly than I did before. In fact, I have been the co-chair of the Democrats Abroad Madrid Chapter’s healthcare reform committee since last summer and have helped organize a letter writing campaign for our chapter’s members to write to their senators and congressmembers, where they are registered to vote in the United States, urging them to support real healthcare reform. 

As you may well know, the national healthcare system in Spain is supported by national income taxes, and patients never have to pay anything when they are seen by doctors and other providers in the system. I get my annual physical checkups and other acute care right at the medical clinic in my neighborhood, which is a modern facility just five minutes’ walk from my house in Madrid. If I have to see a specialist, I get a referral from my primary care physician (PC) at the neighborhood clinic to go to one of the specialist centers, which are located around Madrid and accessible by public transportation. Not too long ago, when I sprained my ankle, I was able to see my PC as a walk-in patient with an urgent need, and later that day I was seen at a specialist center for an X-ray and treatment. The next day, I was given a doctor’s note form from my PC to fax to my job for disability leave, which ended up lasting three weeks in total. I was able to fully recover without worrying because I received full pay directly from my job while I was off on disability, without having to file any additional forms with the Spanish government because once an employee faxes the official doctor’s note form to the employer, the Spanish national healthcare system allows for the government to send the funds to the company to cover the employee’s pay while on disability. I also have friends here in Spain who have had to have more extensive care in the national healthcare system, like maternity care or long-term in-patient cancer treatments, which were all at NO charge to the patient. While no system is perfect (for example, Spain’s national healthcare does not include dental or optometry coverage), it is imperative for countries that want to call themselves civilized to ensure that all inhabitants have preventive and both short and long-term healthcare available to them. Just as Americans value public education for all, we also need to value and support public healthcare for all. I, like many other Americans living abroad, worry about one day returning home and not being able to get healthcare insurance because of a preexisting condition that may have arisen while living outside the U.S. for an extended period. 

I also want to mention that there are private healthcare insurance options here in Spain, which some companies offer employees, and which individuals with the financial means can elect to purchase as additional healthcare coverage in the private healthcare system (without forfeiting national healthcare coverage). In fact, a number of pregnant women who have both options use their national healthcare coverage for all routine maternity wellness checkups/tests and also for their delivery, while simultaneously using their private healthcare coverage to visit a private practice whenever they have an unexpected worry during their pregnancy. Often, these pregnant women are seeing the same practitioner in both cases, because doctors in Spain are able to work in the national healthcare system while also maintaining private practices. So, many of the fears that Americans have about losing choice with a national healthcare program do not have to be a reality, because both systems can coexist. 

In closing, I hope that sharing my personal experience and convictions about healthcare reform will inspire my fellow Americans and our lawmakers to formulate and support effective healthcare reform legislation for all Americans. Finally, I would like to thank you and your staff for your time and consideration of publishing my letter. 


Kelly Thompson is resident of Madrid and Emeryville.