Abstract
Recently, I returned to my alma mater to teach the first American-style medical ethics course at the University of Madrid School of Medicine. Besides the teaching, I visited many hospitals trying to start up discussions about ethics and ethics committees. My work provided me with a close-up look at Spain's health care system, and I came away both impressed with its ideals and shocked by its reality. The socialization of Spanish medicine has been gradual. Franco began the first phase in 1942 when he withheld a percentage of every industrial worker's salary to provide medical care, retirement, and welfare benefits. During the 1960s, the system was expanded to include white-collar workers and even some professional groups. Long before today's socialist party came to power in 1981, the fascist government had extended health benefits to more than 80% of the Spanish population and made an enormous investment in high-tech tertiary-care hospitals.
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