ABSTRACT
The organization of health care in Spain is undergoing major transformations. Most of these stem from changes that have taken place throughout the last two decades (Linz et al. 1982). The end of the Franco period and the consolidation of a democratic system frame the political transformation of the health system (Maravall 1982). The creation of the Sistema Nacional de Salud (National Health System) integrates the processes of change within the system and shapes the current health care complex. The medical profession has also undergone an important change in its structure and political role during these years. For decades, the profession has been a dominant force in defining and controlling the nature of medical work (de Miguel 1976). The transformation of medical care into health care inevitably leads to changes in the political role of the profession, having to share its influence and power with government regulators and corporate and insurance interests. This modification is guided by the revaluation of both state intervention in health care and the political dominance of the profession in designing the organization of the system. The process of transition in the health care system is taking place within a major transformation of Spanish society and its political system (Ministerio de Sanidad y Consumo 1984). New social values and priorities concur with the construction of a new political system and new mechanisms of political intervention.
