[Quality of organizations and the system: It is not the same]

Governance and management, two terms that are barely understood, are precisely defined, and measured. They explain a very important part of the difference between countries, systems, and organizations. Also, in healthcare. The article devotes much attention to the indicators that address the quality of the rules of the game of society, its institutions, showing how the judgment about one or another form of social organization depends on more than one dimension. The good Spanish health system, with a poor prognosis due to its sclerosis of supply and flight to the private sector, needs to be depoliticized and debureaucratized so that the solvency of the health response provides the majority vote necessary for the sustainability of the welfare state. The entire text uses real examples and lands in the Spanish reality, finally distinguishing between what we can influence as citizens and what we as professionals are responsible for.