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Health Care Inequality in Spain After the Economic Crisis: the Health Delivery System and the Public Private Sector Mix

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Abstract

This article seeks to examine the impact of the euro crisis on health inequality in Spain. In particular, this study investigates whether health care inequalities differ across the 17 regional governments, as well as across social classes. This article conducts such an investigation by examining citizens’ attitudes toward access inequalities in the Spanish Health System (e.g., whether citizens believe that the public health care system provides the same services to all people regardless of their socioeconomic status, or their place of residence) along two axes of comparison. First, it analyzes whether citizens’ attitudes toward the performance of health care services differ across regions before and after the crisis. Second, it investigates whether individuals of different social class experience unequal levels of access to health care and the extent to which this is affected by the public/private sector mix in health care delivery.

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References

  • Aja, E. (2003). El Estado autonómico. Federalismo y hechos diferenciales. Madrid: Alianza.

  • Armingeon, K., & Guthmann, K. (2014). Democracy in crisis. The declining support for national democracy in European countries, 2007–2011. European Journal of Political Research, 53(3), 423–442.

    Article  Google Scholar 

  • Arriba, A., & Moreno, L. (2005). Spain: poverty, social exclusion and safety nets. In M. Ferrara (Ed.), Welfare state reform in southern Europe. Fighting poverty and social exclusion in Italy, Spain, Portugal and Greece (pp. 141–203). New York: Routledge.

    Google Scholar 

  • Bonafont Chaqués, L., & Palau Roqué, A. M. (2011). Comparing law-making activities in a quasi-Federal System of government: the case of Spain. Comparative Political Studies, 44(8), 1089–1119.

    Article  Google Scholar 

  • Borrell, C., Fernández, E., Schiaffino, A., Benach, J., Rajmil, L., Villalbí, J. R., & Segura, A. (2001). Social class inequalities in the use of and access to health services in Catalonia, Spain: what is the influence of supplemental private health insurance? International Journal for Quality in Health Care, 13(2), 117–125.

    Article  Google Scholar 

  • Cimas, M., Gullón, P., Aguilera, E., Meyer, S., Freire, J. M., & Pérez-Gómez, B. (2016). Healthcare coverage for undocumented migrants in Spain: regional differences after Royal Decree Law 16/2012. Health Policy. doi:10.1016/j.healthpol.2016.02.005.

    Google Scholar 

  • Cordero, G., & Simón, P. (2016). Economic crisis and support for democracy in Europe. West European Politics, 39(2), 305–325.

    Article  Google Scholar 

  • Costa-i-Font, J. (2005). Inequalities in self reported health within Spanish regional health services: devolution re-examined? International Journal of Health Planning and Management, 20(1), 41–52.

    Article  Google Scholar 

  • Costa-Font, J., & Gil, J. (2009). Exploring the pathways of inequality in health, health care access and financing in decentralized Spain. Journal of European Social Policy, 19(5), 446–458.

    Article  Google Scholar 

  • Gallego, R. (2003). Las políticas sanitarias de las comunidades autónomas. In R. Gallego, R. Gomá, & J. Subirats (Eds.), Estado de bienestar y comunidades autónomas (pp. 102–122). Madrid: Tecnos.

    Google Scholar 

  • Dotti Sani, G., & Magistro, B. (2016). Increasingly unequal? The economic crisis, social inequalities and trust in the European Parliament in 20 European countries. European Journal of Political Research. doi:10.1111/1475-6765.12126.

    Google Scholar 

  • Esping-Andersen, G. (1990). Three worlds of welfare capitalism. Cambridge: Polity Press.

    Google Scholar 

  • Esping-Andersen, G. (1999). Social foundations of postindustrial economies. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Ferrera, M. (1996). The “southern” model of welfare in social Europe. Journal of European Social Policy, 6(1), 17–37.

    Article  Google Scholar 

  • Hall, P. A. (2014). Varieties of capitalism and the euro crisis. West European Politics, 37(6), 1223–1243.

    Article  Google Scholar 

  • Hoynes, H., Miller, D. L., & Schaller, J. (2012). Who suffers during recessions? The Journal of Economic Perspectives, 26(3), 27–47.

    Article  Google Scholar 

  • Jovell, A., Blendon, R. J., Navarro, M. D., Fleischfresser, C., Benson, J. M., Desroches, C. M., & Weldon, K. J. (2007). Public trust in the Spanish health-care system. Health Expectations, 10(4), 350–357.

    Article  Google Scholar 

  • Lago, S., & Cantarero, D. (2012). Decomposing the determinants of health care expenditure: the case of Spain. The European Journal of Health Economics, 13(1), 19–27.

    Article  Google Scholar 

  • Legido-Quigley, H., Otero, L., la Parra, D., Alvarez-Dardet, C., Martin-Moreno, J. M., McKee, & Will, M. (2013). Austerity cuts dismantle the Spanish healthcare system? BMJ, 346, f2363.

    Article  Google Scholar 

  • López-Casanovas, G., Costa-Font, J., & I., P. (2005). Diversity and regional inequalities in the Spanish system of health care services. Health Economics, 14(Suppl1), S221–S235.

    Article  Google Scholar 

  • López-Casasnovas, G., & Saez, M. (2007). A multilevel analysis on the determinants of regional health care expenditure: a note. The European Journal of Health Economics, 8(1), 59–65.

    Article  Google Scholar 

  • Maiz, R., Caamaño, F., & Azpitarte, M. (2010). The hidden counterpoint of Spanish federalism: recentralization and Resymmetrization in Spain (1978–2008). Regional & Federal Studies, 20(1), 63–82.

    Article  Google Scholar 

  • Martín-Pérez, A., & Moreno-Fuentes, F. J. (2012). Migration and citizenship law in Spain: path-dependency and policy change in a recent country of immigration. International Migration Review, 46(3), 625–655.

    Article  Google Scholar 

  • Moreno, L. (2009). Reformas de las políticas del bienestar en España. Madrid: Siglo XXI.

  • Moreno, L. (2002). Decentralization in Spain. Regional Studies, 36(4), 399–408.

    Article  Google Scholar 

  • Moreno, L. (1997). Federalization and Ethnoterritorial concurrence in Spain. Publius, 27(4), 65–84.

    Article  Google Scholar 

  • Moreno-Fuentes, F. J., & De Figueiredo Ferreira, S. (2013). Inmigración, sanidad, crisis económica y politización de la inmigración en España. Revista Interdisciplinar da Mobilidade Humana, 21(40), 27–47.

    Article  Google Scholar 

  • Pavolini, E., León, M., Guillén, A. M., & Ascoli, U. (2015). From austerity to permanent strain? The EU and welfare state reform in Italy and Spain. Comparative European Politics, 13(1), 56–76.

    Article  Google Scholar 

  • Pérez Durán, I., & Rodríguez Menés, J. (2015). Explaining accountability for public policies: an fsQCA analysis of health policy in Spain. European Political Science Review. doi:10.1017/S1755773915000405.

    Google Scholar 

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Correspondence to Ixchel Pérez Durán.

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Durán, I.P. Health Care Inequality in Spain After the Economic Crisis: the Health Delivery System and the Public Private Sector Mix. Glob Soc Welf 3, 179–191 (2016). https://doi.org/10.1007/s40609-016-0074-0

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