When I first came to Spain, I always heard great things about the public healthcare system—universal, free, and worry-free. But in recent years, the experience seems to have gotten worse, especially after the pandemic. Many friends around me have been complaining that booking a GP appointment takes a week or two, and a visit to the emergency room can feel like an eternity. And now, the news is full of reports about GP strikes, which is really concerning.
Healthcare Situation in Major Regions
It seems the strikes and protests are happening nationwide, but they are mainly concentrated in a few major regions, with varying situations. I’ve compiled some recent news and feedback from friends for your reference. Feel free to add information about the situation in your own area.
Community of Madrid: This is arguably the hardest-hit area. The strike by GPs and pediatricians has been ongoing for a while, with their main demands being better working conditions and a reduction in the number of patients seen per day. It’s now extremely difficult to book an appointment with your GP through the “Cita Previa” system of the Spanish healthcare service, and long queues are forming at many community health centers.
Catalonia: The situation is slightly better, but not optimistic. Wait times for specialists are particularly long; waiting over six months for a dermatology or cardiology appointment is commonplace. Many friends have found their GP appointments are becoming rushed as doctors are overwhelmed.
Andalusia: Emergency rooms (Urgencias) are under immense pressure, especially in tourist cities. With more tourists in the summer and a high incidence of flu in the winter, ERs are often overcrowded. There were recent news reports of patients waiting in hallways for over ten hours to get a bed.
Public vs. Private: Should You Get Insurance?
Faced with this situation, many people are debating whether to purchase private health insurance. While the public system is free, the “time cost” is extremely high. You can tough out a minor cold, but you simply can’t afford to wait when something urgent comes up. The main advantage of private insurance is speed—there’s virtually no waiting for specialist appointments or diagnostic tests. The downside, of course, is the cost. A monthly premium of tens or even hundreds of euros is a significant expense.
To help you compare, I’ve created a simple table summarizing the main differences between the public and private systems:
| Feature | Public Healthcare | Private Healthcare |
|---|
| Cost | Mostly free at the point of use | Monthly/annual premiums required |
| Appointment Speed | Very slow, 1-2 weeks for a GP, months for a specialist | Very fast, specialists usually available within days |
| Choice of Doctor | Assigned by the system, no free choice | Free choice of doctors and hospitals within the insurance network |
| Emergency Wait Times | Very long, triaged by urgency | Shorter, generally less crowded |
| Coverage | Comprehensive, including major illnesses and surgeries | Depends on the specific plan, may have exclusions |
If you’re in good health, don’t have chronic conditions, and only need occasional medical care, the public system is likely sufficient. However, if your time is valuable, or if you have elderly family members or children who need frequent doctor visits, getting a private insurance plan as a supplement can provide significant peace of mind. There are many insurance companies on the market, such as Adeslas, Sanitas, Asisa, etc. It’s a good idea to compare their prices and coverage. How did you all make your choice? Any recommendations or bad experiences to avoid to share?
