The genesis, growth and organisational changes of private health insurance companies in Spain (1915–2015)

Abstract

The crisis of welfare states in Europe has offered a growing market share to private health insurance companies. Health insurance is currently one of the fastest growing branches of private insurance business in developed countries. However, much remains to investigate about the origin and evolution of the companies in this sector. This article analyses the genesis, growth and organisational changes of health insurance companies in Spain from the creation of the first medical associations in the 1930s to the modern health insurance companies of today. Spain represents an interesting case study to investigate how changes in the public health model for the long period under study allowed private companies to maintain a changing relationship competitive and partnership with the state.