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本文从五个时期（战后期、扩张期、民主化期、社会党执政时期及医疗改革期）介绍西班牙公共保健制度的产生，以及医疗改革情况。随着有组织医疗的建立，医疗活动由自由行医变为综合医院的医疗服务。国家对医疗业实行控制，医疗市场主要由国家创办，国家为大多数医生提供工作，医生渐渐变为公务员。当医疗市场出现衰退迹象时，国家不采取限制人力资源的措施，引起医务人员过剩，造成紧张局面。医务界和政府因各自的计划不同而产生严重的分歧。
This article describes the emergence of the Spanish public health system and the health care reform from five periods (post-war period, expansion period, democratization period, socialist party governance period, and medical reform period). With the establishment of organized medical services, medical activities have changed from practicing medicine to medical services in general hospitals. The state controls the medical industry. The medical market is mainly established by the state. The state provides work for most doctors, and doctors gradually become civil servants. When the medical market shows signs of recession, the state does not adopt measures to restrict human resources, causing an excess of medical personnel and creating tension. The medical profession and the government have serious differences because of their different plans.