A rapid slump in tax revenues following a long period of escalating public health expenditure has brought funding tensions to the surface. In view of the downbeat forecasts for Spanish output growth, doubts are being voiced as to the financial sustainability of the National Health System. This book addresses these doubts before going on to evaluate several of the reforms now being rolled out in Spain.

Readers can also access the new database constructed for the project, containing regional series of public health expenditure and its composition by public agent.
This publication substantially refines the standard method for analyzing the factors that drive health spending growth – the residual approach – by appropriately resizing the residual, and concludes that inflationary components are a dominant factor.

According to the book’s estimates, in the absence of reforms, Spain’s GDP would have to around 2% in real annual average terms to keep the ratio of public health expenditure to public revenues running at current levels. As this scale of growth is unlikely to be attainable in the next few years, it seems clear that the system’s financial stability is under threat and some elements will need reforming.

This book offers a diagnosis of the sustainability of the National Health System and evaluates a series of reform options. These contents will be of interest to health management professionals and health economics students and analysts, as well as the pharmaceutical and health technology industries.