The authors aim to describe and discuss the likely effects of three recent policy measures related to the financing of the Spanish National Health System which have been introduced over the period 1996–2002 under the conservative Popular Party government. First, tax incentives for private health insurance were introduced with the 1999 income tax reform. Second, in 2002 the devolution of health-services management to regional governments was completed along with reform of the regional mechanism of allocation of public funds (intergovernmental grants, tax revenues, and fiscal accountability). Third, earmarked indirect taxes were introduced in 2002 as a source of additional revenues devoted to public-health financing.
Get full access to this article
View all access options for this article.
References
1.
CalongeSManresaA, 2001, “La incidencia impositiva y la redistributión de la renta en España: Un análisis empírico” [Tax incidence and income redistribution in Spain: An empirical analysis]Papeles de Economía Española88216–229
2.
CastellsA, 2001, “The role of intergovernmental finance in achieving diversity and cohesion: The case of Spain”Environment and Planning C: Government and Policy19189–206
3.
CutlerD, 2002, “Health care and the public sector”, WP 8802, National Bureau of Economic Research, Cambridge, MA
4.
European Observatory on Health Care Systems, 2000Spain 2000WHO Regional Office for Europe, Madrid
5.
FreireJ M, 1999, “La nueva fiscalidad de los seguros sanitarios privados y el Sistema Nacional de Salud” [The new taxation of private health insurance in the National Health System]Gaceta Sanitaria13233–236
IbernP, 1999, “Seguros sanitarios colectivos y desgravación fiscal” [Health insurance and fiscal incentives]Gaceta Sanitaria13236–238
8.
López-CasasnovasG, 1999, “Cost containment in health care: The case of the eighties to 1997”, in Health Care and Cost Containment in the European Union Eds MossialosELe GrandJ, (Ashgate, Aldershot, Hants) pp 401–441
9.
López-CasasnovasG, 2000, “Is there a perfect financing system for health care? Some reflections from Spain”Europe Blanche XXII 13–14 October, Paris, pages 23–32
10.
López-CasasnovasGPlanasI, 2001, “Co-payments in European health care systems: The Spanish approach”, working paper, Pompeu Fabra University, Barcelona
11.
López-CasasnovasGMartínezEDuránA, 2001, “Tratamiento fiscal de los factores de riesgo para la salud y del gasto sanitario: Revisión y propuestas de reforma” [Fiscal treatment of risk factors and health expenditure: Survey and reform proposals]Hacienda Pública Española156(1) 185–203
12.
López-NicolásA, 2001, “Seguros sanitarios y gasto público en España: Un modelo de microsimulación para las políticas de gastos fiscales en sanidad” [Health insurance and public expenditure in Spain: A microsimulation model for fiscal expenditure policies in Spain] WP P.T.N.° 12/01, Institute de Estudios Fiscales, Madrid
13.
López-NicolásA, 2002, “Unobserved heterogeneity and censoring in the demand for health care”, in Econometric Analysis of Health Data Eds JonesA MO'DonnellO, (John Wiley, Chichester, Sussex) pp 181–188
14.
MartínezE, 1998, “Las deducciones en el IRPF por gasto sanitario privado: Situación y posible reforma” [Private health expenditure deductions in personal income tax: Situation and possible reform]Papeles de Economía Española76273–284
15.
NonellRBorrellJ R, 2001, “Public demand for medicines, price regulation, and government–industry relationships in Spain”Environment and Planning C: Government and Policy19119–134
16.
PropperC, 2001, “Expenditure on healthcare in the UK: A review of the issues”Fiscal Studies22(2) 151–183
17.
RicoA, 2000, “Health policy under asymmetric federalism: Twenty years of regional devolution in Spain”Eurohealth6(3) 28–29
18.
RodríguezMSchefflerR MAgnewJ D, 2000, “An update on Spain's health care system: Is it time for managed competition?”Health Policy51109–131
19.
RoviraJDarbàJ, 2001, “Pharmaceutical pricing and reimbursement in Spain”The European Journal of Health Economics2(1) 39–43
20.
WagstaffAvan DoorslaerE, 1999, “Equity in the finance of health care: Some further international comparisons”Journal of Health Economics18263–290
