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Running Head: SPAIN'S HEALTHCARE STUDY 0

Spain’s Healthcare Study

Maria Williams

Southern New Hampshire University

Spain’s Health Care Study

Spain has one of the best health care systems among developed countries. The Spanish Health System (SNS) is universal, which ensures that a majority of people in the country have access to healthcare (Gallo & Gené-Badia, 2013). However, like many other health systems, the SNS has its limitations. Three of the key issues that affect the Spanish health care system include huge health care spending, increasing public health deficits, and increasing pressures due to enhanced demand and use of the system.

Significance of the Health Issues

The Spanish government made a commitment to ensure access to universal health care for all Spaniards. Health care is a constitutional right for each person in Spain. This policy ensures that all people have access to good quality care. However, this system brings about many issues for the country’s health care. Most of the issues that affect this system are connected to the high costs. The main issues identified is the very high spending on health care that helps to keep the system afloat, the constantly increasing health care deficit, and there is an increasing level of demand for health care that will likely make the problem worse in the future. This is a highly significant issue as it will affect the sustainability of the SNS. The current health care spending in Spain is 1.4% above the average of the OECD countries (Avanzas, Pascual & Moris, 2017). The increasing demand for health care means that the problem may get worse in the future. The health care spending deficit will continue to increase and putting more strain on the sustainability of the Spanish health care.

Populations Impacted by Health Issues

The high spending on health care in Spain is covered by the taxes. As health care gets more expensive and demand for health care grows, the government may be in need to collect more resources to meet the increasing needs. The populations that are most impacted by these issues are the lower income earners. The Spanish government has for a long time prioritized health care spending. The increasing cost of healthcare has been a motivation for increasing taxes. Over 71% of the health care costs in Spain are paid through taxes (Aguilar, Bleda, & Centelles, 2019). This means that the cost of health care is just transferred to the taxpayers. As the costs increase, so will their income. Lower income earners have a higher risk of being impacted by these changes.

Social and Cultural Factors

The social demographics in Spain have a big impact on the increasing health care costs. The population of Spain has a high percentage of aged adults. An estimated 17% of the Spanish population, accounting for about 7 million people, are aged above 65 years. Around 25% of the aging population in Spain is above 80 years (Avanzas, Pascual & Moris, 2017). Therefore, a lot of spending goes into care for the elderly. A majority of healthcare spending goes towards aging populations. With such a demographic set-up, Spain continues to require very high costs to take care of its elderly adults. Additionally, the Spanish culture values their elderly adults. Elderly people in pain are respected and valued by their families and community members (Molina-Mula et al., 2019). It is likely that the country will continue to allocate more resources to continue meeting the health care needs of the aging population.

Economic Factors

The high spending on health care and possible increasing demand for the health care services in Spain is putting a strain on the Spanish economic system. Spain has some of the highest spending on health care as a percentage of its GDP. In 2019, Spain spent 9.4% of its GDP on health care. This is around 1.4% higher than the average spending by OECD countries (Aguilar, Bleda, & Centelles, 2019). As the demand increases, the Spanish government may need to inject more money into health care, which will be harder for the economy to handle.

Current Actions

The Spanish government has been trying decentralization as a strategy for dealing with health care costs. The current Spanish health care system is decentralized. There are 17 regional authorities that control the system (Delgado et al., 2018). The government has been in a process of recentralizing care to have better control over the health care spending in the country. The Ministry of Finance in Spain would like to take over control over health care spending to have a better chance at limiting the budget deficits.

The Spanish government has also been trying to change the depth and breadth of coverage. Only 5.5% of health care costs in Spain are covered by private insurers. The government has been gradually reviewing its benefit packages to encourage more people to seek private insurance (Delgado et al., 2018). Such changes help to transfer the burden of health care costs to private companies and less on the government. If this strategy is effective, it can help to ease the pressure of the country’s healthcare on its economy.

Influence of Major Stakeholders and Organizations

Public expenditure accounts for a majority of the Spanish health care system, but there are other stakeholders who play a major role in the survival of the system. There are mandatory health insurance organizations as well as private insurers that contribute to the payment of the high costs of healthcare in Spain (Delgado et al., 2018). These organizations contribute a small percentage to the high health care budget, which helps to reduce the spending deficits. Additionally, there are people who pay out-of-pocket for health care services in the country. Out-of-pocket payments are important in injecting resources into the public health system in Spain (Delgado et al., 2018). Most importantly, a lot of non-profit organizations have made significant impact to the improvement of the cost issue in the Spanish healthcare system. These organizations help people at the community level to meet their health care costs (Delgado et al., 2018). They are significant to the injection of funds to the Spanish health care system.

Recommendations for Improvement

It is unlikely that the demand for health care will reduce. The health care spending issue will continue to persist unless changes are made to the cost of care. Proving good quality care in Spain will require investment into the reduction of healthcare costs so that the government can reduce the amount of money spent to ensure all people have access to quality care. One of the recommendations is to take advantage of technologies that reduce care costs. Technologies that can reduce administrative costs such as electronic records should be used in the right manner. All organizations can improve on their spending if they invest in technologies that enhance efficiency in their care delivery processes. Secondly, it is recommended that the government of Spain continues with its decentralization efforts. If the government can get more control over the finance aspect of the healthcare system, it will be easier to examine the potential areas that are taking up unnecessary costs and making the necessary changes. The central government will have a better chance at controlling costs if it has a role to play in the budgeting practices of the country’s health care system.

References

Aguilar, M. G., Bleda, J. G., & Centelles, C. G. (2019). Immigrants in the Spanish public healthcare system: participative and general healthcare matters. Revista espanola de salud publica93.

Avanzas, P., Pascual, I., & Moris, C. (2017). The great challenge of the public health system in Spain. Journal of thoracic disease9(Suppl 6), S430.

Bernal-Delgado, E., García-Armesto, S., Oliva, J., Martínez, F., Repullo, J., Peña-Longobardo, L., ... & Hernández-Quevedo, C. (2018). Spain-health system review. http://www.euro.who.int/__data/assets/pdf_file/0008/378620/hit-spain-eng.pdf?ua=1

Gallo, P., & Gené-Badia, J. (2013). Cuts drive health system reforms in Spain. Health Policy113(1-2), 1-7.

Molina-Mula, J., Gallo-Estrada, J., & Miquel-Novajra, A. (2019). Attitudes and beliefs of Spanish families regarding their family members aged 75 years and over who live alone: a qualitative study. BMJ open9(4), e025547.