Adhesion to a health insurance is done through the professional network or voluntarily. Primary care is provided in public health centres. To receive care in hospital you must have a prescription for a general practitioner except in case of emergency. Hospitals provide secondary and tertiary care as well as emergencies. Portugues hospitals are classified into five groups: - Group I: Hospitals providing some internal medicine and surgery services and some specialities like oncology, hematology. This depends on the type of population and the framework set by the Central Administration of the Health System. - Group II: Hospitals providing some internal medicine and surgery services and some specialities that are not able in Group I's hospitals. - Group III: Hospitals providing all internal medicine and surgery services and all specialities that are not able in Group II's hospitals. - Group IV: Hospitals specialized in oncology, internal medicine, rehabilitation, psychiatry and mental health. The lack of coordination between hospitals and primary care centres and the fact that many people went directly to the emergency room. without going to a general practitioner before, have led to the creation of local health units that include one or more hospitals as well as primary centres. These units were created according to geographical location, the balance of specialties and the availability of emergency services. According to the World Health Organization (WHO), in 2014, total expenditure on health reached 9.5% of GDP, i.e. $2,690 per capita. Spain The Spanish public health system is universal: anyone in need of medical care can apply for it, even those who are not affiliated to the Spanish Social Security and who, in case of need, can go to the emergency room for treatment. People without Social Security and without the European Health Insurance Card must pay for health care. The Spanish national healthcare system covers almost every Spanish. It is financed by taxes, so that Spanish do not have to pay directly for it. Hospital treatment can be provided in different types of hospitals: - General hospitals from the national health system: they provide care in different specialties (internal medicine, general medicine, paediatrics, radiology, orthopaedics, obstetrics and gynaecology, etc.). - Regional hospitals: they provide tertiary treatment or very specialized care which require advanced technologies. They are located in urban zones. - National reference centres specialized in specific pathologies. - Private hospitals under contract. According to the World Health Organization, in 2014,