Spain’s Healthcare Crisis… or Thursday, Everywhere Else
My latest article—and my debut in the Spanish publication El Salto—has just gone live. 🎉
The piece focuses on Torrejón, a town whose healthcare “situation” is so dramatic it could be mistaken for satire… if it weren’t also happening across the entire Spanish public health system.
But wait—before anyone abroad feels too smug—this isn’t just a Spanish phenomenon.
Canada is cracking.
The NHS is held together by chewing gum and nostalgia.
And in the U.S., they’re still debating whether healthcare should even exist unless it’s called Obamacare and then promptly threatened with extinction.
In other words: Torrejón is not the exception. It’s the preview.
If you’re curious (or simply enjoy observing slow-motion institutional implosions), you can read the original Spanish version here:
👉 https://www.elsaltodiario.com/sanidad/torrejon-no-es-un-escandalo-es-plan
And for everyone wondering, “But where’s the English version?” — don’t panic. It’s right below.
P.S The spider was real.
The complete and absolute terror in his eyes bore through the night like a signal flare no one would ever see—a distress call swallowed whole by the black. Sweat poured off him in hot, uneven waves; every tremor twisted his limbs into new, sharp angles until his skin became a shuddering Etch A Sketch of bruises, blotched shapes blooming and dissolving like mold time-lapsed across his body. They writhed in sync with the rotting labyrinth of stains on the motel’s 1970s carpet—tobacco-colored swirls and psychedelic oranges—patterns that looked like they’d come alive purely out of spite, inching upward, ready to drag him into whatever fungus-slick underworld waited beneath that sagging bed.
Outside, the swamp pressed against the walls as though trying to squeeze its way inside. The relentless shriek of unseen insects, the wet rasp of things dragging themselves through muck, and the heavy, suffocating humidity of the northern Florida night all thickened the air until every breath felt borrowed, like something with more legs than us had already breathed it. The room was shrinking. He was shrinking. He was dying.
He drifted in and out of consciousness, surfacing only long enough for a single phrase—some buried splinter of memory—to scrape its way out of his throat. The venom roiling through his veins twisted the words, but the cadence never changed. A mantra. A warning. A plea.
Each time his chapped lips began to move, I leaned closer, close enough to feel the heat of his fever against my cheek, expecting to hear him call for his mother, or reach for some childhood prayer that might anchor him to the world.
But no.
That wasn’t it at all.
The only thing he said was, “Don’t take me to the hospital.”
And in those six words the grotesque, carnivorous irony of the situation bared its teeth. Here we were, in the richest country in the world, a short drive from world-class medical care, watching a man who had been working earlier that same evening die from a spider bite because he didn’t have health insurance and couldn’t afford a night in the ER. His final thoughts weren’t about survival, they were about the far greater terror of living long enough to be hunted by debt collectors.
What made it all even more obscene was how close salvation was. This wasn’t some remote village lit by a single generator. This wasn’t a place where healthcare was a rumor. This was suburban America—big box stores, six-lane highways, and a hospital whose parking garage alone cost more to build than entire health services in the developing world. They had the antivenom for a brown recluse bite sitting in a refrigerator fifteen minutes away. Perfectly chilled. Perfectly accessible. Perfectly useless.
So instead of professional care, we gave him the last dusty antihistamine rattling around in my shaving kit since the Bush administration. It was like trying to put out a house fire with a half-empty bladder.
And of course, the question rose between us—quiet at first, then louder with each violent spasm: If he died, would we be held responsible? Would we be liable for not delivering him to his financial ruin? Was failing to bankrupt a man now some kind of crime?
This is the conundrum—the American miracle reduced to its purest, most feverish form: the freedom to choose between death and debt.
What happened in that Florida motel wasn’t an American anomaly — it was a preview. A trailer for the feature film now being screened across Spain under the seductive titles of “innovation,” “efficiency,” and “market-driven modernization.”
In the upcoming elections the powers that be will try to divide us into neat little camps, as if the labels ‘right’ and ‘left’ can somehow contain the vast, ungovernable weirdness of the human animal. They’ll carve us up like we’re sides of political beef: “lean conservative,” “marbled liberal,” “grass-fed centrist.” And we’ll be expected to moo accordingly.
Yes, we can be loosely arranged on a spectrum when it comes to crucifixes in classrooms, taxing the ultra-rich, legally tolerable amounts of lead in your drinking water, or whether immigrants should be treated as humans rather than suspiciously mobile furniture. But outside the anomaly of a nation that knowingly elected a convicted felon and suspected pedophile to the highest office in the land—and then asked if he could serve dessert—most of the developed world has been operating on a few basic axioms for the last half-century: totalitarianism = bad, liberal democracies = good. Tito, Uncle Enver, and Ceausescu = absolutely unhinged. Hitler, Mussolini, and Franco = do not invite for dinner. Somewhere between those extremes lay the grey zone we all allegedly wanted to inhabit.
And in that grey zone, for decades, there were a few sacred spaces we agreed capitalism shouldn’t sink its teeth into. The police and the courts were supposed to be “equal” for everyone, at least on paper. Education—especially early on—was meant to be the great equalizer, the societal booster seat that gave every kid a fighting chance. And then there was healthcare. The idea of profiting off death was considered gauche in polite society, morally repulsive, like showing up to a funeral wearing a wedding dress. Categorizing some diseases as “premium revenue opportunities” while others were “loss-leaders” was the kind of thing that got you excommunicated to a mahogany-paneled office deep in the FAES desert.
And then something changed. A slow creep at first, like mold behind the wallpaper. Shockingly, it didn’t even start on the right. PSOE governments in Andalusia were gradually convinced—coaxed, lobbied, seduced, bribed, take your pick—that there was money to be made from pneumonias. Pneumonias! As if the lungs of a pensioner were suddenly a diversified investment portfolio.
This is the future Spain has been told to applaud as “innovative,” “efficient,” and “market-driven.” A future where the hospital isn’t a sanctuary—it’s the monster under the bed. And not the playful Pixar kind. No, this one has spreadsheets for teeth, EBITDA for eyes, and a capitation contract stapled to its forehead. A monster that measures your pulse in euros and your prognosis in quarterly returns.
But the wild thing—the rabid, hysterical punchline—is that we don’t even need to guess what happens when you invite this beast into the health system. We already know. The numbers are out there. The “radical leftist” Lancet (that infamous guerrilla medical journal) has the receipts: when public systems are handed over to private operators, quality goes down, equity collapses, and the poor get tossed aside like underperforming assets. The moment healthcare becomes a business, people become line items, and the sick become liabilities leaking red ink.
Spain isn’t being warned about this. Spain is living it.
In the underlit corridors of the Hospital in Torrejón, something extraordinary happened: the monster spoke out loud. In a leaked boardroom recording—truly a chef’s-kiss moment of neoliberal candor—the executives behind Ribera Salud laid out the business model with all the tenderness of a vulture explaining its diet. They spoke of identifying “unprofitable processes,” delaying care to maximize margins, and of course that old chestnut: stretching “single-use” materials into “multiple-use” ones.
Austerity, but make it biohazard.
It was the quiet part said so loudly you could hear Milton Friedman clapping from the grave.
And the model behind it all? Capitation. A magical payment system where the hospital gets a flat fee per resident, meaning the fewer patients they treat—and the sicker the ones they avoid—the more money they make. It’s an efficiency dream, assuming your dream is a dystopian spreadsheet where the optimal number of treated patients is zero.
Meanwhile the waiting lists grow, the public clinics wither, and a chorus of think tanks insists this is proof that the public system “doesn’t work anymore.” Of course it doesn’t work. They starved it. They drained it. They left it on life support long enough for private equity to swoop in wearing a cape and shouting “innovation!”
I remember when you could get a same-day GP appointment. Now people wait so long they qualify not for medical attention, but for archaeological classification.
And this—this creeping, fungal privatization—is where the true right–left divide actually lives. Not in flags. Not in crucifixes. Not in pearl earrings, yacht-club sweaters, or nostalgic promises that everything will forever remain Spanish and orderly and pure.
The real political divide is this: Do you believe healthcare is a human right, or a corporate revenue stream?
Because if your vote goes to the Nice Smiling Candidate who tells you pork will stay on the menu and Catalan will never infiltrate the kindergarten, but buried in the fine print is the privatization of your hospital system, then congratulations—you have traded your biopsy results for nationalism and your chemotherapy for cultural comfort.
And yet people were shocked—shocked!—when the Torrejón scandal broke. When CEOs talk openly about delaying care, about turning emergency rooms into profit centers, about reusing medical supplies like they’re rinsing out Tupperware containers in a gas station bathroom. They clutch their pearls as if this were some unforeseeable act of villainy rather than the inevitable logic of a for-profit healthcare model.
This is what corporations do.
They monetize.
They optimize.
They cannibalize anything that isn’t nailed down.
If that includes your kidneys, well, kidneys are replaceable. Profit margins aren’t.
So when election day comes, the question isn’t whether you’re left or right, red or blue, nationalist or globalist. It isn’t about flags or languages or nostalgia for a Spain that exists only on postcards.
The question is brutally simple: Do you want a healthcare system, or a billing system?
Do you want a doctor, or a shareholder?
Do you want treatment, or an invoice?
Do you want to die from a spider bite because the ambulance ride costs more than your car? If you want to understand where our healthcare system is heading, don’t look at campaign ads. Look at that motel room in Florida. That is the end zone of the game they are asking you to play.
After a long night, my friend in Florida survived. He clung to consciousness just long enough to dodge bankruptcy. He escaped the ER, not through recovery, but through fear. And years later, when a serious pneumonia finally dragged him back into the system he had spent a lifetime avoiding, the prophecy fulfilled itself: he was scanned, his credit card was captured, his insurance status processed, and he was diagnosed with stage-four lung cancer and promptly sent home with aspirin for the pain. No beds for grifters.
He didn’t die because medicine failed him.
He died because the business model worked exactly as intended.
