Spain is part of a small group of countries in southern Europe, together with Cyprus, Greece, Italy, Portugal and Malta, where the system is essentially private, with hardly any government funding, and patients have to pay at least 90 per cent of the cost. The other countries have a dental health system which is either State-funded or mixed, according to the report from the Spanish Dental Association. As well as the Spanish model and the other Mediterranean countries, the study highlights five others:
The Nordic model (Denmark, Finland, Norway and Sweden) consists of a public dental service which is accessible to everyone, free for children (in some cases up to the age of 19) and with extensive facilities for adults. In the case of Sweden and Denmark, orthodontics are included for children, and in Finland free dental treatment is provided for priority groups (under-18s, people with psychological disability, those with chronic illnesses and recovering addicts).
The Eastern European model (Czech Republic, Estonia, Hungary, Lithuania, Latvia, Poland, Slovakia and Slovenia) involves a traditional health service system, but since the Berlin Wall came down the trend has been moving towards private treatment.
The ‘Bismarck’ model (Austria, Belgium, France, Germany and Luxembourg) is different because there is practically no free dental treatment. In this case, dental care is provided by the private sector with payment per treatment (generally official rates) and patients are reimbursed afterwards by insurance companies.
The British model is based on dental services provided by private dentists with contracts with the health authorities. Some services normally have to be paid for, but are free for under-18s, students, pregnant women and people with limited resources.
The hybrid model (Ireland and Holland) is mid-way between the ‘Bismarck’ model (for the adult population) and the British model (free dental care for children).