Reforming Spanish health care: a matter of survival.
Gallo and Gené-Badia report on the most important hanges in the Spanish healthcare system as a result of he financial crisis and the preliminary impact of these hanges on the health of the population. The authors ightly state that cost reduction has been the chief drivng force and that the unpopular measures undertaken o far have not counted with the support of the main ctors involved in their implementation, including healthare professionals and some regional health authorities [1]. ome specific, evidence-based interventions may help reddress the worrying situation of the Spanish healthcare ystem. The current situation of the Spanish National Health ervice (SNS) may be unsustainable. Spain cannot coninue to accumulate deficits while making cuts that may ffect the quality of healthcare and health outcomes. In ddition to economic woes, the system is imperiled by ther elements, including total structural debts, growing hronic illnesses, an aging society, expensive, inadequately valuated, new technologies, and disproportionate medialization [2]. With a few exceptions, Spain has not used the risis as a chance to increase quality and efficiency, reoranize and rationalize health services and recover public onfidence and credibility. Therefore, reform is necessary. ne way of introducing reform would be to mimic the aradigm of evidence-based medicine: fund what works nd cut back what does not. When evidence is robust, act. hen it is incomplete, look for better awareness to inform ecision-making.