From time to time I observe or I receive news about certain situations that are a direct consequence of the administrative subdivision of Spain into several “autonomous regions”. These are always negative situations for the people, and I see them as proof of my theory about the fact that this administrative subdivision is really something negative for the people in the whole country.
Recently I’ve learned about the case of a student of medicine, graduated from the University of Granada (in the autonomous region of Andalucia). She is currently working for the preparation of an exam to opt for a position of specialization, at a hospital in Madrid (different autonomous region). Later on she intends to move back to Granada, but in Andalucia they won’t simply take her experience in Madrid as valid. An additional exam will be necessary to prove her experience, because she did her preparation exam outside of Andalucia, which does not recognize the tests performed by Madrid.
That is, artificially two medical systems have been established in one same country, and they do not cooperate closely, but rather they create obstacles to the free movement of professionals within the country.
This division of medical and health system administration (and of other systems) among the autonomous regions is an absurd strategy. It implies the creation of multiple health care administration bodies, within a relatively small country, thus multiplying the cost of operating the health care system. Instead of adopting an strategy to reduce the percentage that management costs represent over the total cost, the choice was to create several health care administrations. The overall management cost percentage is higher when each autonomous region has to administer its own health care, compared to a single health care system that serves the whole country.
The result is that fewer resources remain for the actual objective of the health care system: patient care. Moreover, unnecessary bureaucratic procedures are implemented, making the system work more inefficiently. This is but another proof that the administrative subdivision of Spain into autonomous regions is an error, a catalyst for the inefficiency of the public administration in the service that it must provide to citizens.