The right to health care in Spain: right to Social Security or public health care?

Abstract

Since the enactment of the General Health Law in 1986, whose purpose was to implement the right to health care for all Spaniards as guaranteed under section 43 of the Constitution, there has been a separation between the exercise of the right to public health care and the right to social security. This process, despite its implementation together with the National Health System and the different Health Public Services, and the change in the health coverage, which from FY 2001 is part of the general taxation, has not reached a final split-off. Consequently, in almost all scenarios, the access to public health care was preceded by the recognition of that right not by the Health Care Bodies, but by the Common Services of the Social Security (the National Social Security Institute and the Navy Social Institute), irrespective of all the subsequent regulations (in 2002 and 2013) that insisted on the proclamation of the right to a universal heath care differentiated from the Social Security scheme.

In 2012 and by means of the Royal Decree-Law, of 20th April, which established urgent measures to ensure the sustainability of the National Health System and improve the quality and safety of its benefits, among other aims, a series of measures have been incorporated, which lead to the strengthening of the existing relationship between the access to the National Health System benefits and the right to health care, through the Social Security, by recentralising the competencies in the realm of health care in favour of the Common Services of the Social Security. For these benefits to become effective it is necessary that the individuals concerned, as insured party or beneficiary, are entitled to that health care right which is only recognized by the Common Services of the Social Security, as stated in the Royal Decree-Law 16/2012 with the application and development rules contained in the Royal Decree 1192/2012, of 3rd August, by which the status of insured party and beneficiary are regulated for Spanish health care purposes, from the National Health System public funding.