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Since decentralization of Spanish government, questions have remained as to developing policy that effectively impacts both regional and national population. Spain has developed an efficient socialized healthcare program. Due to the decentralization process, however, certain regions of Spain have developed far more advanced policy mechanisms. In particular, Catalonia steps outside the traditional rolls of government oversight to forecast visionary policy and policy-making techniques. Amidst the tug of war between willingness and resistance to implement healthcare policies that have a dedicated impact on improving the population health and healthcare, Catalonia employs original thinking and innovation in policy using the Health in All Policies (HiAP) model to create comprehensive strategies. By integrating health into every policy put forth, Catalonia ensures decision-making that prioritizes citizen health first and foremost. When all shareholders are on the same plane, better conversations can be facilitated to better avoid potential issues. Health, as this policy paper explains, is aspect of life that interweaves all other socioeconomic factors. Policy changes must be introduced to improve communication and coordination amongst regions and on a national level, thereby introducing horizontal, collaborative partnerships. The accountability that exists as a main tenet of HiAP limits the presence of the free rider issue in government at all levels. This paper demonstrates the needed nuanced conversations that compel policy-makers to work together to further advance effective efficiency in socialized medicine.
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