Spain’s national systems of medicine and healthcare have been regarded as both points of help and hindrance amidst the global public health crisis ignited by the rise of COVID-19. Spain’s overall case count exceeds 94,000 as of Tuesday morning, with a death tally of over 8,000. It can be noted that prior to the outbreak, the Spanish healthcare system was praised as a demonstrative example of successful universal healthcare. While the responses to the coronavirus outbreak in Spain should not serve as evidence against the effectiveness and morality of universal healthcare overall, they should lead to an investigation into which aspects of this positively heralded system have led to Spain’s current pandemic conditions.

Reports that deceased nursing home residents may have been abandoned in the beds have surfaced. In response, sociologist Marina Subirats stated (via the New York Times) that “[Spain has] really kept a welfare state and a strong family support structure, but this terrible news coming from nursing homes must also force us to acknowledge some very serious deficiencies.” Thus, cultural rhetoric must be approached critically, especially when it comes to conditions on the ground and testaments from first responders during these times of international crisis. The Spanish newspaper, El País, has referred to Subirat’s sentiments similarly as a reflection of a “bitter black hole in our welfare state.” That healthcare and medicine are understood in relation to welfare shows how socially democratic institutions are needed to establish a hybridized system of national public health.

It is of particular importance to conceptualize the impacts of COVID-19 as context-informed responses to the institutions built for crisis mitigation of this nature. The ideology which views health and medicine as a commodity that must be paid for is not upheld well by an exponentially growing health emergency. The concept of for-profit health during an actively unfolding public health disaster is truly ridiculous. It displays the bleak discrimination inherent in private health. We should not necessarily be publicly denouncing Spain for the partial privatization of public health. But instead, we should observe and note the trends and patterns, especially when cherry picking which lives should be saved.

As discussed previously, Spain does have a national public health system. According to the news outlet Jacobin, the legislation was enacted in 1989, along with the provision for guaranteed universal care. This signalled political victories for the working class left, in addition to anyone requiring healthcare, and the policies have been a point of pride for Spanish citizens. These alignments have only been strengthened at this point in the nation’s COVID-19 outbreak, despite the system’s shortcomings being revealed through this crisis. Many aspects of Spain’s public health system have been privatized over the past several years, particularly in Madrid, the nation’s coronavirus capital, according to Jacobin. Spain’s center-right Popular Party, in addition to the center-left and Catalonian independence groups have all pushed for the marketing of public goods and resources to private care companies under the guise of care improvement.

Beyond mere exposition, COVID-19 in Spain has pulled back the curtain on the intricacies of good collective health and universal care. The intermingling of public and private health resources has certainly contributed to Spain’s unfolding contexts in crisis.