Abstract
The aim of this paper is to analyze the effects that recent health reforms adopted in Spain because of the economic crisis have had on the National Health System. It is not only a matter of mere budgetary cuts or measures of saving in the public expense. Reforms are looking for the efficiency and financial sustainability of health care services. However, a «mutation» in the public service has taken place. Reforms have affected the basic principles of the public system: the insurance model, its universality, the financing of the system and the principles of equity and cohesion of the public service.
Highlights
analyze the effects that recent health reforms adopted in Spain
because of the economic crisis have had on the National Health System
Reforms are looking for the efficiency
Summary
Resumen: El objeto de este trabajo es analizar los efectos que las reformas adoptadas recientemente en España, con motivo de la crisis económica, han tenido en el servicio público sanitario. No se trata solo de meros recortes presupuestarios y de medidas de ahorro en el gasto público. Las reformas buscan la eficiencia y la sostenibilidad económica del sistema sanitario. Han producido una importante «mutación» del servicio público que ha afectado a sus principios básicos inspiradores, al modelo de aseguramiento, a su universalidad, a su financiación y, con ello, a los principios de equidad y cohesión del sistema. Palabras clave: sistema público sanitario – sostenibilidad del sistema – universalidad – reformas sanitarias – servicio público – copagos – cobertura sanitaria – derecho a la protección de la salud – inmigrantes irregulares
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