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There are several important differences between the two documents. The United States Declaration allows individuals to freely express their opinions about their health. This means that an individual can declare, for example, that he or she wants to see a doctor only if they feel their physical health is declining. However, Spanish law does not allow for medical opinions. Instead, individuals are required to file a medical declaration, indicating what health issues they are facing and how they intend to address them.

A significant difference is that a Spanish health insurance company cannot ask for personal information about an individual. If an individual feels that he or she has been subjected to discrimination because of his or her health, he or she can file a complaint with the General Trade Commission (CAD). This agency is responsible for investigating any discrimination and determining if the practice is illegal. Complaints regarding the privacy of health declarations are also handled by the Civil Service, the Public Defender's Office, and the Ministry of Education.

The CAD, the Madrid office of World Health Organization, works closely with the Ministry of Health. The CAD's mission is to monitor and improve Spain's public healthcare system, including its health insurance systems. The new Directives for Health System Activities have changed the format of health declarations forms. These directives state that health declarations form must be drawn up according to local legislation and must be submitted for approval before they are used.

Health Insurance Directives state that any person who wishes to avail of any kind of health care must fill out a health insurance declaration. All citizens have the right to a health insurance card which will provide them with free treatment by qualified medical professionals. The card will be cancelled if the person refuses to admit to a medical condition or submits incorrect information during the application process.