The Grandpa from Hell died in August of 2010. The following winter, my mother and her sister managed to drag Grandma to the doctor; the doctor could not find Grandma’s last blood results, which she wanted to check to see if there were any “danger points” (things which don’t quite merit a diagnosis but which should be watched).
Mom asked “Mama, have you been to the doctor since you last came to my house?”
“What? NO! Of course not! You go to the doctor you get sick!”
“Her last blood tests were in 1994, when she came to Navarre to have her gallbladder out. I don’t think the records were electronic yet.”
“blink Well then, guess we’ll do some and see if we can make her sick!”
Her bloodwork came out fine, apparently she was immune to doctors.
So, I can say that my grandmother who died at the tender age of 102 years and 350 days once went without so much as a check-up for 16 years, but I can also say that she didn’t seem to need one. Once she was living in an old folks’ home she got general checks at least once a month, blood work every three months and her numbers were gloriously in the middle of the ranges. Several doctors jokingly referred to them as “irritatingly healthy.”
For her last years, we knew she had some sort of internal bleeding; work to detect the source would have started with a colonoscopy. The home had two medicalized plants but wasn’t equipped for colonoscopies. If she’d wanted to have it checked, she would have been taken by ambulance to Sant Pau and spent between two days and several weeks there depending on how long it took to find something and on what exactly was found. Out of pocket cost would have been zero. But, since she had made it very clear that she didn’t want treatment for anything that wasn’t immediate pain, and since our family respected her wishes, she didn’t get treatment. She was even and repeatedly asked about the bleeding and her response was “one must die of something! It doesn’t hurt, leave it be.” My aunt joked that she really wanted to take a walk around Sant Pau and see the results of the recent remodel; my cousin proposed taking one of the guided tours instead.
Admittedly, most of our hospitals aren’t that pretty 
My mother does have a complaint about Spanish Social Security: they appear to have relented now, but for a few years they kept trying to medicate her “just in case”. You’re postmenopausic? Have calcium supplements. “Why? How do you know I need them? Shouldn’t you take a densitometry?” “… at your age, most women”“at my age, most women don’t drink several glasses of milk a day. At my age, I was told years ago I’d be in a wheelchair, do you see a wheelchair? Do that densitometry. At my age, most people can’t pronounce densitometry, I’m not taking another pill unless I need it!”
She takes that calcium supplement now, but got started on it over a decade after that wave of Just In Cases.
My sister in law has multiple complaints about Spanish Social Security, but she’s a doctor. Many of her complaints are actually about her coworkers personally; my favorite is “bah, the Medical Director of our local hospital is Medical Director because he’s good at paperwork, as a doctor he’s no big shakes so it’s no loss he doesn’t practice.” Me, I’m glad the guy found his niche.
I do have an issue, but it’s on the management side. We’ve moved from “one money bag, one nation-wide administration” to something similar to the Canadian system with every region having its own administration (the money bag is still one). It makes coordinating services more complicated; several regions have ended up creating bi- or multi-lateral agreements so they can do things like send someone who lives close to the line to the nearest hospital (which is in another region) rather than to the hospital that’s nearest within their own region. It also means that moving to a new region carries the question of what will you need in order to get a local doctor assigned; in most regions you need your ID and to spend a few minutes in line, but a couple make it more complicated.