Borges, Fabiano TonacoLopez Fernandez, Luis Andresde Sousa Campos, Gastao Wagner2025-01-072025-01-072018-07-010104-1290https://hdl.handle.net/10668/24643This theoretical essay analyzes the fiscal measures adopted in Spain as a response to the economic crisis of 2008, its implications to the Spanish National Health System (SNS) and the social response. We performed a case study having as primary source of information the narrative of a social actor who participated in the Spanish reform. We also used secondary sources to gather socioeconomic data and performed a literature review of 20 articles published in the 2014 Sespas Report. SNS was implemented by a progressive growth of healthcare coverage, complete funding by taxes and Primary Health Care-based organization. Austerity measures imposed cuts on the health care budget, reduced the roll of services delivered, introduced co-payments, and moved the universal coverage back to meritocracy. Critical political economy pointed out that the purpose of the measures on fiscal policy is to regressively redistribute income and wealth. The Mareas Ciudadanas constituted themselves as a citizen response with success in many social struggles against austerity. The alternative of resistance and overcoming through a political path is strongly present in Spain and is resisting the dismantling of SNS.ptAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Social WelfareHealth SystemsPublic PoliciesHealth EconomicsSpainresearch articleopen access10.1590/S0104-129020181800431984-0470http://www.scielo.br/pdf/sausoc/v27n3/en_1984-0470-sausoc-27-03-715.pdf449638700007