The Essential Role of Private Health Insurance in Spain
In Spain, one in four people have private health insurance. This sector is responsible for 29.7% of hospital admissions, 33.6% of emergency treatments, and 41.6% of surgical interventions, according to the latest data from the IDIS Foundation. This organization integrates the main hospital groups, private clinics, and insurers in Spain, as detailed in its Private Health Sector Observatory 2025.
Private health care comprises 26% of total health expenditure and 2.48% of national GDP. Today, 56% of Spanish hospitals, equating to 431 centers, are private, accounting for 31% of hospital beds. Notably, 12.4 million Spaniards opt for dual coverage—public and private—while 1.66 million officials (76%) choose private insurance. This results in approximately 8,000 surgical interventions and 125,000 consultations in private facilities every day.
The data speaks volumes, indicating that without the contribution of private health, the National Health System (SNS) would struggle to function as it does today. However, its role is often perceived as a “fundamental piece in terms of care capacity, economic impact, employment generation, research activity, and health training.” Yet, this contribution is frequently viewed as a supplementary support to the SNS.
Why is that? Marta Villanueva, General Director of IDIS, shares that viewpoints from a health policy perspective. “To improve population welfare and access to healthcare, we need to consider the health system in its entirety. This is not merely about finances but rather about intentions,” she asserts.
The two systems—public and private—function as separate entities with some collaborative synergies. The question arises: What would happen if the population had better integrated management of both? Villanueva believes, “Both systems are complementary and essential in catering to the healthcare needs of the Spanish population, especially given the saturation and waiting lists present in the National Health System, to which the private sector provides relief.
The Welfare State and Private Health
Luis Mayero, a counselor at Asisa-Lavinia, echoes this sentiment, emphasizing that “private health is essential for supporting our health model.” Together with the pension system, it forms the backbone of our welfare state. Private insurance users conserve public resources, as they often consume fewer resources from the SNS. According to estimates, the benefits paid by private insurers yield nearly €7.5 billion in annual savings to the SNS.
Consequently, Mayero concludes, “The Spanish health system cannot be imagined without the contribution of private health.” This necessity will only grow as the population expands, costs rise, and resources remain limited. Effectively utilizing all available health resources is imperative.
A Complex Relationship
Villanueva underscores that it is time to recognize the private sector’s undeniable role in healthcare, with over 300,000 people employed and 71,000 doctors on staff. Beyond statistics, the private health system is described as “more resilient, faster, efficient, and more adaptable to market needs,” capable of incorporating innovative technologies and responding to investment requirements promptly.
Mayero adds that the operational efficiency seen in private health enables quick responses to changes in care demand, especially through digitalization, telemedicine, and home care services, where the private sector has been a pioneer.
The influence of private health extends to clinical trials, with over half already conducted in private facilities. Mayero emphasizes that large private hospital groups are redefining strategic and development plans, focusing on smaller hospitals and specialized medical centers that operate in a collaborative, multidisciplinary manner to ensure rapid patient recovery and monitoring.
This experience shapes private health into an engine of innovation and improvement for the healthcare system as a whole. Many technologies and management models initially tested in the private sphere are now gradually being integrated into public health.
A final key distinction of private healthcare, according to Villanueva, lies in its focus on the patient experience and its commitment to foster a prevention culture. This includes introducing new care models, such as “liquid hospitals,” designed to provide ongoing care for increasingly chronic populations while reserving traditional hospitals for acute cases.
A Call for Collaboration
Given its contribution to GDP and various health metrics, the private sector should play a more proactive role in managing and organizing health resources in Spain. Moreover, there should be no distinction between health systems in Europe. For instance, recent regulations regarding the European Health Data Area emphasize unique patients and medical records rather than focusing on system ownership. This aligns with the IDIS Foundation’s stance advocating for a unified healthcare model: healthcare without differentiating labels.
The ideal scenario is seamless healthcare delivery, as experienced during the pandemic, when it became clear that the pandemic could not have been effectively addressed without the private sector’s integral contribution. Moving forward, private health organizations aim to normalize their roles as complementary agents in healthcare delivery.
Indeed, certain synergies already exist through public-private partnerships, such as concerted public centers or specialized services where private sector involvement directly benefits patient care. Mutualism—a well-established model for public-private collaboration—enhances accessibility for many citizens, particularly for the 76% of officials who opt for private health services.