The Ebola crisis has revealed severe deficiencies in how the American health care system works, experts say.
In the heart of Madrid, nestled in an ancient building adjacent to the historic Plaza Mayor, a small firehouse is charged with protecting some of the city's most cherished cultural heritage. Within striking distance of its two battered fire engines are some of Madrid's oldest buildings, many bearing signs indentifying their illustrious former tenants: the writer Miguel de Cervantes, the painter Diego Velázquez, the playwright Lope de Vega. The majestic 17th Century Santa Cruz Palace housing the Foreign Ministry is within eyeshot of the station. The Reina Sofía Museum, home to Pablo Picasso's Guernica, is a short ride away, as are emblematic buildings housing the Prado Museum, Congress, and the Royal Palace.
Now, the firehouse is scheduled to be sold and turned into a luxury hotel and spa. The cash-strapped Madrid government quietly made these arrangements last fall, hoping not to attract public attention.
But Madrid Mayor Ana Botella, wife of former president José María Aznar, did not count on the city's vociferous firefighters, who have interrupted city council meetings and hung banners from the building warning neighbors that their "safety is for sale."
So far they have collected over 50,000 signatures against the station's closure, which would leave Madrid's most densely populated neighborhood in the hands of a firehouse about one mile away: a four-minute to ten-minute increase in response time, depending on the traffic.
"The buildings in this area have mostly wooden structures and in case of a fire every second counts," said station chief Claudio Turrión, a 34-year veteran, as his team tried to crank up the motor of one of the 20 year-old fire engines.
The area attracts millions of tourists each year and has thousands of shops, hotels, and restaurants along its clogged, narrow streets. It also has a large population of elderly people who live alone in walk-up apartments.
"In many cases we get to the fires in the nick of time," Turrión said, adding that, "as it is, firefighters are having to perform miracles with inadequate equipment and with increasingly shrinking salaries and benefits."
The firehouse story illustrates how the economic crisis and the brutal austerity measures adopted by Spain's local and national governments are affecting every nook and cranny of life, particularly in the beleaguered public sector.
In early January, over 300 doctors resigned en masse in Madrid from their jobs as directors and administrators of more than 100 public health centers to protest the move by Madrid's conservative regional government, the Partido Popular (PP), to privatize the sector. The doctors say that the plan to hand over the management of 27 health centers and six public hospitals to for-profit companies is motivated by financial and political interests and will not help to reduce the public deficit.
The mass resignations by doctors came right after a five-week strike by thousands of Madrid health care workers aiming to pressure the Madrid authorities to backtrack on the privatization efforts. One hundred and fifty doctors also resigned in December from their jobs as hospital advisors.
"We are quitting because the government refuses to listen to us, the medical experts, on what is best for our patients," said Fátima Brañas, who leads one of the main doctor's associations.
In December, hundreds of experts from the health care sector presented the Madrid government with a cost-cutting financial alternative to privatization, but so far their recommendations have been ignored. The mass resignations did, however, prompt Madrid authorities to announce the creation of a commission to negotiate with health care workers.
The government has not made public any documents or numbers demonstrating how the privatizations, tailored after the failed British effort to privatize the National Health Service, could save the system money.
Prior privatizations in health care have mostly benefited two large for-profit health care corporations, including Capio, owned by the European private equity firm CVC, which last year made over €600 million from its Madrid health care concessions.
Spain has one of the world's most equitable public health systems that until recently guaranteed universal access to all levels of care. In the name of the crisis, the national government, also of the PP, has slashed the public health care budget, putting a severe strain on workers and patients and sparking demonstrations, strikes, and other forms of doctor-patient protests all over the country. Several doctors have gone on hunger strikes to protest what they say is the dismantlement of the public health system.
The Spanish government cut off health care access to undocumented immigrants in late 2012, leaving hundreds of thousands of people without care and leading health care providers all over Spain to declare themselves conscientious objectors to the law. Spain's Constitutional Court annulled the measure in December, ruling that it violated the constitutional right to health care access for any person residing in Spain, regardless of their legal status.
The efforts by the Partido Popular to partially privatize health care and education began well before the economic crisis hit Spain. In autonomous regions where the PP governs, including Madrid and Valencia, it has been implementing such policies for years. But the crisis has provided the PP with an excuse to accelerate the privatizations.
Health care is not the only sector affected by privatization. While it slashes the public education budget, the PP is also channeling more public money to charter schools mostly run by the Catholic Church. Other public services, from street cleaning to school lunch programs, are increasingly in private hands.
Meanwhile, almost anything seems to be up for sale in Spain. Vulture funds are buying up malls, mortgage debt, housing developments and other property in Spain at cut-rate prices.
In January, a vulture fund made an offer to buy the airport of Castellón, which has attracted international attention as one of Spain's most embarrassing symbols of waste and corruption during the housing boom. Built for €150 million under the watch of Castellón regional president Carlos Fabra of the PP, its runway, decorated with a statue of Fabra, has never seen an airplane land.