Between the German Model and Liberal Medicine

The Negotiating Process of the State Health Care System in France and Spain (1919-1944)

Abstract

This work draws on legal and medical sources, and data from the general and workers’ press to study the negotiating process of the State Health Care System in France and Spain between 1919 and 1944. It shows how, given the internal and external circumstances of both countries, the first phase of this negotiation happened at the end of the First World War; and, how France and Spain’s own systems were initially modelled on the German social insurance, but the final result was different due to the doctors’ opposition. In France, the offensive of medical syndicalism led to the establishment in 1930 of a model of compulsory health insurance, which respected the principles of liberal medicine. Meanwhile in Spain, the doctors’ opposition prevented it from being realised until the new circumstances after the Civil War acted as the driving force for the establishment of a model similar to the German system.