The Spanish are among the world's healthiest people with an average life expectancy of 80 for women and 74 for men which is the highest in the EU. The incidence of heart disease in Spain is among the lowest in the world, partly attributed to the Spanish Mediterranean diet.

The Health Care System

The healthcare system in Spain is extensive and well-developed. It is ranked seventh best in the world by the World Health Organization. The system is centralized with each of the country's 17 regions (comunidades autonomas) takes individual responsibility for implementation and execution within their respective locale.

Barcelona's system is governed by the Catalan Public Health system, or CatSalut Servei Catala de la Salut.

There is a combination of both private and public healthcare. People in possession of a Spanish social security number and the necessary medical card are entitled to receive free or low cost healthcare. There are occasional staff shortfalls, but that is mitigated by the option to apply for private healthcare.

Expat Care

Expats interested in health care must first get a social security card at the Social Security Treasury Office(Tesoreria de la Seguridad Social). Only expats who have successfully arranged a work or resident's permit and have obtained their Empadronamiento are eligible for social security. Once you have obtained this, you should receive a medical card at the local clinic.

Some Non-European Union citizens are protected by bilateral agreements. Some of these include:

• Peru
• Paraguay
• Ecuador
• Chile
• Brazil
• Andorra

These allows for free hospitalization and medical care in cases of medical emergencies or accidents. Patients must present the corresponding health certificate from the country of origin. If a certificate is not available, pay up front and receive reimbursement.

General Practitioner/Doctor

Although patients are not able to select their provider, medical professionals in Spain are usually efficient and well educated. Establishments in big cities employ personnel who speak English or offer the services of interpreters.

Physicians function as quasi-civil servants and are paid a salary based on seniority and credentials. This reduces incentive to treat patients incorrectly or issue false charges. However, the pay is lower than other OECD countries resulting in fewer doctors and nurses per capita.

How to Find a Doctor

Spaniards can not choose their physician. They are assigned a primary care doctor who must refer the patient in the case that specialist services are needed. Patients are not allowed to change doctors unless they have private insurance.

Patients must register with a doctor with their Spanish social security number after registering at the local Ayuntamiento (town hall). Another requirement is that you must have the empadronamiento (registration) for at least three months old. Note that the paperwork and services are in Spanish, so if you are not completely familiar bring a friend or advisor.

If you are in need of specialized treatment, your doctor needs to refer you to other specialist departments.

Wait Times

Wait times are one of the primary issues with the system. The average wait to see a specialist in Spain is 65 days. Waiting times for procedures are also long, up to 62 days for a prostectomy and 123 days for a hip replacement.

Payment

Healthcare is a constitutionally insured right and treatment is generally free or very low cost. Prescriptions do require payment.

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