the autonomous health services. Without interfering with the diversity of forms of organization, management and services inherent in a decentralized system, it attempts to establish certain basic, common safeguards throughout the country. This law attempts to establish collaboration of public health authorities with respect to benefits provided, pharmacy, health professionals, research, health information systems, and the overall quality of the health system. Toward these ends, the law created or empowered several specialized organs and agencies, all of which are open to the participation of the autonomous communities. Among these are the Agency of Evaluation of Technologies (Agencia de Evaluación de Tecnologías, Spanish Agency of Medicines and Medical Devices (Agencia Española de Medicamentos y Productos Sanitarios), the Human Resources Committee (Comisión de Recursos Humanos), the Committee to Assess Health Research (Comisión Asesora de Investigación en Salud), the Charles III Institute of Health (Instituto de Salud Carlos III), the Institute of Health Information (Instituto de Información Sanitaria), the Quality Agency of the National Health System (Agencia de Calidad del Sistema Nacional de Salud) and the Observatory of the National Health System (Observatorio del Sistema Nacional de Salud). The basic organ of cohesion is the Interterritorial Council of the Spanish National Health Service (Consejo Interterritorial del Servicio Nacional de Salud de España), which has great flexibility in decision making, as well as mechanisms to build consensus and to bring together the parties taking such decisions. A system of inspection, the Alta Inspección, assures that accords are followed. Royal Decree-Law of Urgent Measures to Guarantee the Sustainability of the Sistema Nacional de Salud and Improve the Quality and Security of its Prestations (2012) The Royal Decree-Law 16/2012 was introduced on April 20, 2012. It puts into law severe cuts in the Spanish National Health System, including the following: Refusal to give assistance to unregistered foreigners (in effect from September 1, 2012). This hasn't been applied by all the comunidades autónomas. Increase of the percentage of medicines paid by the user: Senior citizens didn't pay for medicines before the reform, but now they pay 10% (limited to €8/month if their income is ≤€18,000 a year, €18/month if their income is >€18,000 and ≤€100,000 a year, or €60/month if their income is >€100,000 a year). Workers now pay 40% if their income is ≤€18,000 a year, 50% if their income is >€18,000 and ≤€100,000 a year, or 60% if their income is >€100,000 a year. Governing