Introduction Of Compulsory Health Insurance Research Articles

The Mechanism of Phased Introduction of Compulsory Health Insurance and Assessment of its Financial Burden

The healthcare financing mechanisms and volumes don’t correspond with the development requirements of the sector. Any state, including RA, needs large-scale financial resources to ensure universal health coverage of the population, train the necessary number and quality of specialists, create centers equipped with the latest medical equipment, and provide quality services. Along with this, the spread of chronic diseases in the country, the aging of the population, and significant out-of-pocket costs require the introduction of a mandatory health insurance system. The main goal of the research is to define the mechanism of the phased implementation of compulsory health insurance and the calculation of the financial burden of each stage of that system, as well as the calculation of the per person annual insurance premium in case of introduction of compulsory health insurance in RA.

HEALTH INSURANCE: OPPORTUNITIES FOR DEVELOPING ACTIVE TYPES AND OPPORTUNITIES FOR INTRODUCING COMPULSORY HEALTH INSURANCE

This article discusses the importance of health insurance in the social protection of the population, the importance of its wide promotion among the masses, as well as the need to refine the system for the phased introduction of compulsory health insurance and its introduction to the masses. The directions for the development of voluntary medical insurance are also identified, as well as aspects that impede the introduction of a mandatory type, and instructions are given for their elimination.

Ključni izazovi u reformisanju zdravstvenog sistema Srbije u uslovima pandemije COVID-19 na putu ka održivom i decentralizovanom sistemu

Health care is the most important activity and human kind is dealing with its organization for centuries. Public health policies and functional health care systems have as their primary objectives the preservation and improvement of public health. Problems of intensive aging of the population, continuous growth of health spending, ensuring sustainable financing of health systems and efficient use of resources are present in all world health systems. Health care system reforms have become a global phenomenon for the last twenty years of the last century. The goal of this review paper is to point out the importance and need for timely modifications of the strategy of the health care optimization plan in Serbia by 2035, so that the health care system of Serbia would be ready to respond to potential global health crises in the future. The Plan for optimizing the health care institutions network by 2035 as a key document of the Master Plan will be briefly presented with an analysis of key parameters of health care effectiveness and above all improvement of the implementation of basic principles of health care - uniformity and availability of health services on the territory of Republic of Serbia. In order to present future key changes in the health system, it is necessary to take into account the current situation, as well as the potential consequences of the global pandemic of COVID-19 virus on health systems. Databases were used for analysis: WHO, OECD, World Bank Reports. The tendency of increasing the share of health care costs in GDP, with the problems of efficient use of health care resources, is becoming the most important reason for reforming health insurance and health care in almost all countries in the world. Numerous researches of eminent experts in the field of economy and finance indicate that the introduction of compulsory health insurance with a clearly defined package of health conditions is the most rational choice in the implementation of the World Health Organization project: "Health for all in the 21st century". A health system could be said to be effective if it provides health care of maximum quality in terms of medical outcome, with minimal costs in relation to the allocated funds. Health care systems around the world today face very similar problems, and the COVID-19 pandemic has shown how "vulnerable" it is not only the health system but all of humanity when faced with such challenges.

БЮДЖЕТНИЙ МЕХАНІЗМ: ВИКЛИКИ СЬОГОДЕННЯ

The definition of "budgetary mechanism" was analyzed in the article. It is described as a form by which the fund of financial resources is managed by influencing economic entities. The components of the budgetary mechanism that do not function effectively and lead to cyclical consequences in particular, the deficit of budget funds, tax pressure on taxpayers and, as a consequence, the accumulation of public debt, are identified. The shortcomings of certain components of the budget mechanism are substantiated, in particular: budget planning and forecasting; as analysis showed, are carried out inconsistently with each other. Thus, the State Budget of Ukraine is formed not depending on the capacity of the economy and its subjects, but depending on the needs of passive budget items. Passive budget items are growing systematically. There are a number of remarks on the applied forms of the budgetary mechanism, for example, payment of taxes and customs payments to the budget is ineffective, because a significant share of taxes is in the "shadow". Therefore, the amount of shadow budget funds is 30%, including smuggling 9.3%, payment of salaries in envelopes 5%, offshore schemes 3.6%, conversion centers 1.8%. The reasons for the inefficiency of the budgetary mechanism in terms of legal support are systematic changes in legislation, which are sometimes caused by lobbying motives. Ways to improve the budgetary mechanism are identified, for example, comparison of macroeconomic forecasts and budget planning; involvement of business in the processes of macroeconomic forecasting and budget planning; de-shadowing of the economy, including transparent payment of salaries through the implementation of a progressive taxation; payment of customs duties; State budget discharge through the introduction of compulsory health insurance and additional pension insurance levels.

ABOUT THE DYNAMIC DEVELOPMENT OF THE HEALTH AND PHARMACEUTICAL SECTOR IN AZERBAIJAN

Introduction: In the Republic of Azerbaijan in the period 2009-2019 years for the implementation of large-scale measures for the dynamic development of healthcare, decrees were signed on the approval of the State Program for the implementation of the development of the National Strategy in this, mainly, this is strengthening the material and technical base of medical institutions, the use of modern methods of examination and treatment, improving the quality of medical and pharmaceutical services to the population, state regulation of prices for essential medicines, training and improvement of personnel, introduction of compulsory health insurance [1,2,3]. Goal: The purpose of this work was to study the new economic foundations of financing the healthcare system in Azerbaijan, analyze the reforms in healthcare and the pharmaceutical sector, and apply them in practice. To achieve this goal, a number of local regulatory laws, as well as the activities of medical and pharmaceutical services to the population, were studied. Discussion: During this period, our country has taken extensive measures to solve problems in the field of healthcare and the pharmaceutical sector. The regulatory legal acts governing pharmaceutical activities have been approved. In particular, state regulation of prices in the sphere of circulation of medicines has been introduced to prevent unjustified increases, as well as the application of measures of liability provided for by the legislation of the Republic of Azerbaijan for violation of the pricing procedure for medicines included in the list of essential medicines. In accordance with international standards, the quality control of medicines has been strengthened, the rules for issuing medicines have been improved, new prescription forms have been introduced, and admission to doctors is monitored [4,5]. Keywords: healthcare, pharmaceutical sector, reform analysis

MEDICAL INSURANCE IN UKRAINE: PROBLEMS AND PROSPECTS FOR DEVELOPMENT

The article examines the current state of health insurance in Ukraine, problems and prospects for the introduction of compulsory health insurance as one of the sources of funding for health care. The basic principles of compulsory health insurance are considered. The directions and expected results from the medical reform in Ukraine are considered, taking into account the experience of foreign countries. An analysis of the number of insurance companies in Ukraine was made, as well as a rating of Ukrainian insurance companies in the field of health insurance was built and presented. Ways to overcome the crisis period in the domestic health care system have been identified. The main stages of implementation of compulsory and voluntary insurance as a single complex are considered. The main stages of the implementation of compulsory and voluntary insurance as a single complex are considered. The main tasks of health insurance development in Ukraine and directions of improvement of this process in the context of Ukraine 's accession to the European Union are determined.

Problems of implementation of compulsory health insurance in Ukraine

This article summarizes the arguments and counterarguments within the scientific discussion on health care financing by introducing compulsory health insurance in Ukraine and improving voluntary one. The study’s primary purpose is to theorize and determine the main directions and recommendations for implementing compulsory health insurance in Ukraine. Systematization of scientific background concerning the study problem showed that Ukrainian national and municipal health care institutions didn’t provide free medical care in the amount and quality guaranteed by the Constitution of Ukraine. Therefore, the relevance of solving this scientific issue is the necessity of comprehensive health care reforming (especially funding) considering compulsory health insurance. To achieve this goal, the study was conducted in the following logical sequence: analyzing models, historical experience, and a hybrid budget insurance system of health care financing; identifying the Ukrainian health insurance features during the pandemic in 2020; clarifying the problems of health insurance development in Ukraine and the world; analyzing and considering the theoretical base on solving health insurance issues; retrospective analysis of the three-level insurance model; developing the practical recommendations for improving the mechanisms of compulsory health insurance implementation. The methodological tools of the study were the methods of dialectical scientific knowledge, systematic approach, statistical and comparative analysis, a review of scientific background, regulatory framework, and insurance companies’ reports. The study involves data for 2002-2021. The object of the study is the health insurance system and state mechanisms for regulating compulsory and voluntary health insurance in Ukraine. The obtained results showed that the introduction of compulsory health insurance in Ukraine addressed the expanding availability of medical services to the general population and attracting additional resources in health care. The study empirically confirms and theoretically proves that the Ukrainian government should determine the main health services provided and the insurance premium amount, coordinate the interaction between insurance parties, resolve conflict situations, provide the legal basis for the system functioning, control financial flows and activity insurance fund. The study results can be helpful for insurance market professionals, financiers, and economists in the health care industry, researchers, and students of economic specialties.

Conceptual bases for reforming the national health care system: to the formulation of principles

The article is devoted to the problems of reforming domestic health care. First of all, what is worth paying attention to is the formulation of principles. Principles for public administration in the field of public health. The aim. Formulation and justification of principles on which the reform of domestic health care should take place. Materials and methods of research. The dialectical method was used to analyze the current state of domestic medicine. The system-structural method was used to analyze the public availability of care and to organize it was provision at the primary level. The introduction of compulsory health insurance in Ukraine was investigated using methods of analysis and synthesis. Results. Having extensive experience in the organization of public health protection both in Soviet times and in the conditions of independent Ukraine, the author states the following: public access to medical care consists in the possibility of equal access of citizens to the possibilities of medicine regardless of property or social situation, place of residence and the like. In the context of today's attention is focused: it is not about ensuring quality, comfort, namely the availability of medical care. The first two factors really depend first and foremost on the financial capabilities of the person, we are talking about accessibility here. And ensuring accessibility is a state task. Any state tries to promote it. It is argued that the fact that most patients receive medical care at the primary care level is not a secret. Focuses on the introduction of compulsory health insurance. Realities show that most of the world's leading countries have chosen this path in the organization of medical activities. The organizational and legal advantages of this type of insurance are undoubted. First of all, it is the introduction of contractual relations between the subjects of health insurance (patient, medical institution, insurance medical company, employer), changes in the system of financing the medical sphere, and improvement of control over the quality of rendering medical services. Conclusions. It is stated that the basic requirements for the principles of public health management should be: realism, complexity, and perspective.

ОСОБЛИВОСТІ ФУНКЦІОНУВАННЯ СВІТОВИХ МОДЕЛЕЙ ФІНАНСУВАННЯ ОХОРОНИ ЗДОРОВ’Я

The main goal of any country's health care system is to improve the health of the population and life expectancy. Studying the experience of developed countries allows to make reasonable proposals for improving the existing model of healthcare in Ukraine.Research into the practical aspects of the functioning of health care, its financing and development is a priority.The issues of adapting the experience of developed countries to the model of financing health care in Ukraine, taking into account the socio-economic state of its development, remain unsolved in full.The purpose of the article is to analyze the existing global models of health care financing and leading countries, as well as to identify areas for adapting foreign experience to the Ukrainian model of health care financing.There were analyzed the three major models of health care in the world. The advantages and disadvantages of each of them are identified, as well as the areas of implementation suitable for Ukraine. The experience of the leading countries in eachof the studied models -Great Britain, Germany, USA is considered.The study allowed to obtain systematic information on global models of health care and identify areas for improvement for Ukraine (development of state insurance programs, introduction of compulsory health insurance, increasing the level of innovation).

Bismarck’s Health Insurance and the Mortality Decline

Abstract We study the impact of social health insurance on mortality. Using the introduction of compulsory health insurance in the German Empire in 1884 as a natural experiment, we estimate difference-in-differences and regional fixed effects models exploiting variation in eligibility for insurance across occupations. Our findings suggest that Bismarck’s health insurance generated a significant mortality reduction. Despite the absence of antibiotics and most vaccines, we find the results to be largely driven by a decline of deaths from infectious diseases. Further evidence suggests that statutory access to well-trained doctors was an elementary channel. This finding may be explained by insurance fund physicians transmitting new knowledge on infectious disease prevention.

VECTOR FOR THE DEVELOPMENT OF MEDICAL INSURANCE IN THE CONTEXT OF MODERN MEDICAL REFORM IN UKRAINE

Introduction. The current practice of functioning of the medical sector shows the existence of problems that impede the introduction of compulsory health insurance in Ukraine, the effective development of its voluntary form. At the same time, the problems of development of medical insurance under the influence of crisis phenomena of the national economy are deepening. The purpose of the article is to develop recommendations for improving medical reform in Ukraine. Results. The most controversial moment in the reform of health care was the rejection of free medicine, the right to which is enshrined in the Constitution of Ukraine. However, budget medicine in Ukraine will still remain, however, in what volumes and at what stages of provision of medical services or medical care is not yet defined in the Ministry of Health of Ukraine. The negative trend of the contracted health model is the creation of an authorized body that will not only implement health policy but, in fact, formulate this policy: to define state guarantees, needs for medical services and to check the quality of these services. And this is a huge threat, because Ukrainian medicine will be in a worse situation than it is now. We believe that the policy-making function should remain under the Ministry of Health of Ukraine. The negative aspect of modern medical reform in Ukraine is the lack of requirements for the formation of medical treatment protocols. This can be explained by the fact that patients will continue to prescribe treatment that is untrue. Instead, for the health insurance, the insurance company would monitor costs and control the appointment of treatment for the patient, the price of medical services. In this context, we propose to adopt the Law of Ukraine “On Compulsory Health Insurance”, which stipulates and clearly defines the rights and obligations of the insurer, the insurer, the list of services, their price, a single register of insured persons, the formation of the Social Health Insurance Fund and a differentiated approach to categories of the population. Conclusions. The experience of developed countries of the world proves that achieving this goal is possible through the introduction of insurance medicine. Insurance medicine is a real alternative to budget financing, which is no longer capable of ensuring the constitutional right of citizens to receive unpaid health care. The development of health insurance is an objective need, which is dictated by the need to ensure that healthcare receives funds. At the moment, the study of the question of the necessity of introducing compulsory health insurance is probably very relevant to all. Successful market reforms in Ukraine are impossible without the formation of an effectively organized health insurance market that can guarantee the preservation and strengthening of human health, improving the quality of medical services and the level of human life.

Evaluation problems introduction of compulsory health insurance and the operation of the voluntary health insurance in the realities of the systemic crisis in Ukraine

The article presents the results of the analysis of the problems the introduction of compulsory health insurance and the Voluntary Health Insurance in a systemic crisis, which is observed in Ukraine and domination paternalistic model of social policy. The authors marked particularly the introduction of insurance relations in the health care system and the pharmaceutical provision of the population. The authors identified the main characteristics of the domestic market of voluntary medical insurance and perspective directions of its development. In the article noted that the effectiveness of the introduction of compulsory social model and operation of the voluntary of medical insurance requires the development of a whole complex of toolkits. Using this tool will allow to coordinate the process of reforming the national health care system and the pharmaceutical provision of the population with the Ukrainian realities of economic development and the characteristics of the formation of public opinion.

АНАЛІЗ ПРОБЛЕМ ТА РОЗРОБКА ЗАХОДІВ ЩОДО ПІДВИЩЕННЯ ЕФЕКТИВНОСТІ ФАРМАЦЕВТИЧНОГО ЗАБЕЗПЕЧЕННЯ ХВОРИХ НА ЛЕЙКОЗИ В УКРАЇНІ

<p align="center"><strong>ANALYSIS OF PROBLEMS AND DEVELOPING MEASURES TO IMPROVE THE EFFECTIVE OF THE PHARMACEUTICAL PROVIDING PATIENTS WITH </strong><strong>LEUKOSIS</strong><strong> IN UKRAINE</strong><strong></strong></p><p class="tecst" align="center"><strong>G. L. Panfilova, </strong><strong>О</strong><strong>. V. Tsurikova</strong></p><p align="center">NationalPharmaceuticalUniversity,Kharkov</p><p><strong>Summary:</strong> The article presents the results of the survey of physicians of oncology and hematology at a range of issues relating to the organization of medical and pharmaceutical care to patients with leukosis in Ukraine. Evaluation of all the physicians who participated in the survey, problem-solving in the organization of effective medical and pharmaceutical care must be realized in the plane the introduction of compulsory health insurance in the healthcare practice.</p><p><strong>Keywords:</strong> expert survey, leucosis, pharmaceutical care, pharmaceutical providing</p><p><strong>Introduction.</strong> According to the National Cancer Registry leukosis steadily occupy the first position in the structure of morbidity and mortality from malignant neoplasm’s among the age group from 0 to 17 years. Important role in determining the direction of overcoming the problem of low efficiency of medical and pharmaceutical care to patients with leukosis is opinion analysis oncologists and hematologists. These groups of physicians are an essential element that connects patients and pharmacists in the pharmaceutical provision of hematological patients.</p><p><strong>Methods.</strong> The study used a logical, comparative, graphic and statistical method of analysis and of scientific search. The objects of research were selected results of the expert survey of oncologists and hematologists physicians, conducted during the years 2012-2014 in various regions of Ukraine.</p><p><strong>Results and discussion</strong>. According to the results of data processing survey found that in rating the importance of factors that influence prescription, took the leading position of clinical and economic factors and regulatory and legal content. According to physicians, unimportant factors are those associated with traditional application of different chemotherapy regimens. By unimportant factors physicians classified as one that is due to the possibility of the use of a name of the drug under conditions of absence of more effective drug. It is proved that the vast majority of experts only partially satisfied with the level of organization and financing of health care and pharmaceutical providing patients with leukosis. The main directions of solving this problem 100% believe the introduction of compulsory medical insurance in Ukraine. Almost every second expert noted a low level of satisfaction of needs of drugs. More than half the respondents consider it inexpedient to give preference domestically produced drugs at the budget procurement of drugs. Installed contradictory attitude of experts to assess the frequency of prescriptions drugs procured by the state. More than half of physicians believe that they have sufficient information on new drugs and chemotherapy leukosis. Physicians believe the most appropriate use of the work such sources of information as «analytical and brief overview», «annotations in monographs magazine articles, etc.». More than three-quarters of physicians indicated that their hospitals are absent pharmacies of state (municipal) ownership. The 56 of experts consider it appropriate opening in their hospital pharmacies of state (municipal) ownership. More than half of physicians assessed the level cooperation of pharmacies and the hospital where they work as «satisfactory». Physicians believe that the main factor that affects the level of cooperation between the pharmacy and the hospital are «affordability of drugs». According to the opinion the overwhelming number of physicians, the main problems in pharmaceutical providing of leukosis patients are «low income of the population» and «insufficient budget financing program «Oncology»». Great importance, according to the majority experts, is a lack systematic and clear state policy in the pharmaceutical sector of Ukraine. The results of our studies developed measures to improve pharmaceutical providing patients with leucosis in Ukraine. Offered by us are measures should be implemented at the macroeconomic and microeconomic level.</p><p><strong>Conclusion.</strong> The results of the research, a list of measures to improve the efficiency of pharmaceutical providing of leukosis patients in Ukraine. These measures should be implemented at two levels (macroeconomic and health facility level).</p>

“Community Integrated Health and Social Services” Conference February 21 - 22, 2014, Bucharest, Romania

As in many countries in Eastern Europe, the Romanian Health care system was characterised by hospital-based, specialised and centrally managed health care services up to the 1990s. Decentralisation, the introduction of compulsory health insurance and the development of family health services were major steps towards improving access to curative and preventive health services at community level. However, community nursing, which had previously provided outreach to the rural poor, was practically abandoned in the mid-1990s when the salaried general practitioners providing primary health care services for a catchment population were transformed into private practice family doctors with health insurance fund service contracts, providing care based on lists of insured patients. Hence, the community nurses/ health visitors that had been hired previously within the public primary health care setting found themselves unemployed. Community level health prevention and public health services, as well as services for pregnant women, mothers and children, were subsequently stopped. A few mother and child health programmes tried to redress this problem during the early 2000s and some good practices have been documented. The new vision for Romania, The Romanian Government National Strategy for Health 2014 – 2020 [1], addresses this service gap and foresees the development of sustainable integrated socio-medical services at community level. Since 1992, longstanding cooperation between Switzerland and Romania has connected the two countries. After a period of limited collaborative activities following Romania’s accession to the European Union, Switzerland restarted programme activities within the framework of an EU agreement supporting new accession countries. The main goals of the current Swiss support programme are to reduce social and economic disparities between Romania and more advanced EU countries, and between regions within Romania. To this end, Switzerland and Romania signed a Thematic Fund Agreement in 2011, called the Reform Fund linked to Health Issues, effective until 2019. The Swiss Agency for Development (SDC) [2] has mandated a consortium of the Swiss

Evaluation of pharmacotherapy of patients with hypothyroidism by the methods of frequence, ABC-, VEN-analyses

The article presents the results of a comprehensive clinical economic analysis of patients with the iodine deficiency syndrome and hypothyroidism. The study was conducted at the Regional Clinical Hospital of Ivano-Frankivsk. As it is evidenced by the results of frequency analysis, in total 244 prescriptions of 73 drugs – an average of five prescriptions per a medical history sheet were made for 47 patients. In most cases for the treatment of patients L-thyroxine (Berlin-Chemie AG, Germany), which 85% of patients received, was used. However, taken into account the great number of prescriptions for various drugs, L-thyroxine was prescribed only in 16.4% of cases in general. Besides the replacement therapy with L-thyroxine, patients mostly received treatment of concomitant diseases. The list of drugs, which cost was about 80% of the total cost of therapy (group A cost) was determined by the ABC-distribution method; the part of them was 18% in the total names of drugs. Group B was comprised of 31% of all medicines, which cost was 2034.19 UAH – 15% of the total cost of pharmacotherapy. The part of group C by cost was 6%, it contained the largest number of drugs – 37, which was 51%. The results of the combined ABC/VEN-analyses determined that the highest proportion of costs for the pharmacotherapy conducted fell to the drugs of group N being secondary by importance. Group E was represented by 12 drugs. And the necessary group V was represented only by three drugs (6.4%). The ABC/VEN-analyses conducted confirmed the conclusion of frequency analysis since expenditures were distributed irrationally concerning the importance of the drugs according to the clinical protocol. After the introduction of compulsory health insurance in Ukraine this state of distribution of expenses would be unacceptable.

Overview of Recent Cases before the Court of Justice of the European Union and the European Court of Human Rights (July – December 2012)

In the period July–December 2012 both the Court of Justice of the European Union (CJEU) and the European Court of Human Rights (ECtHR) delivered a number of important rulings that are worth reporting. The present overview discusses four CJEU judgments, two dealing with the rules determining the applicable legislation (Partena ASBL v Les Tartes de Chaumont-Gistoux SA and Format) and two involving benefits aimed at promoting access to employment (Caves Krier and Prete). In addition, the overview covers the notable ECtHR decision judgment in Ramaer and van Willigen v. the Netherlands, which seems to mark the end of a long legal battle that Dutch pensionado's have fought against the introduction of compulsory health insurance in 2006.

“Un-American” or unnecessary? America’s rejection of compulsory government health insurance in the Progressive Era

Between 1915 and 1920, 18 U.S. states considered the introduction of compulsory health insurance. Progressive reformers expected state health insurance to be welfare enhancing for American wage-workers since it would result in lower cost insurance and an extension of coverage to more of the population. The evidence presented in this paper indicates that the absence of broad political support for health insurance legislation in this early period reflects that compulsory insurance would not have improved on what was available and affordable through voluntary arrangements and had the potential to reduce the welfare of wage-earners.

The Dutch health services before compulsory health insurance, 1900-1941.

By 1930, almost all the Dutch population had access to basic medical care encompassing general and specialized medical services, hospital care and community services. The system by which this had been accomplished was determined by the fact that central government was unwilling to accept responsibility for health care by stimulating public services or regulating health insurance. In general, the poor were cared for out of municipal medical relief funds while the rest of the working classes were able to participate in voluntary sickness fund insurance schemes. The middle and upper classes had to rely on private practice, yet they found it increasingly difficult to pay for expensive hospital admissions. Moreover, the financial limitations of voluntary insurance, as well as the dominant position of the medical profession vis-à-vis sickness funds, meant that most funds did not cover hospital care or community services. The actual delivery of these services was often in the hands of private organizations but the municipal authorities paid most of the costs, either through direct payment or through subsidies. Before the introduction of compulsory health insurance in 1941, the highly independent Dutch municipalities did not only care for the poor; they also provided hospital care and community services for almost the entire population. This brought about wide geographical variations in the Dutch health services.

The system of comprehensive assessments of environmental factors and monitoring of public health

The state of health of the population of the Republic of Tatarstan is in the focus of attention of state organizations, scientific institutions and the general public. The adoption of a number of laws and by-laws on health protection and health care reform, the introduction of compulsory health insurance and their implementation create new conditions for the development of health care. At the same time, the socio-economic situation, which led to the decline in production and entailed difficulties in financing at all levels, as well as other factors have a significant impact on the health status of the population [2]. Factors associated with individual characteristics of behavior, such as smoking, alcohol consumption, nutrition, physical activity, etc., are also of great importance in shaping the health of the population [5, 6, 7].

Enfermedad y previsión social en España durante el primer franquismo (1936-1951)

The campaign against tuberculosis was one of the main health tasks undertaken by the Francoist regime from the beginning of the Civil War. At the same time, the project to introduce compulsory insurance against tuberculosis was initiated, based on the Italian model of social insurance. This article analyzes the circumstances that impeded the implementation of the insurance program. One determining factor was the division of power among the different factions of the Francoist regime, which led to the introduction of compulsory health insurance by the Falangist Party. Relevant features concerning the organization and goals of the anti-tuberculosis campaign in Spain from 1936 to 1951 are also described.