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Spain’s national health system (SNS) offers virtually universal, tax-funded healthcare that is free at the point of care, with responsibilities decentralized to regional governments and coordinated nationally by the Ministry of Health. Recent reforms have focused on reinforcing universal access, equity, and financial protection, especially for vulnerable groups, while addressing challenges such as workforce shortages in primary care and access disparities in rural areas. Although Spain performs well in health outcomes compared to the EU, with high life expectancy and low avoidable mortality, gaps remain in areas like mental, dental, and optical care, as well as in ensuring efficient use of healthcare resources.