Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE) & Department of Public Health, University of Barcelona, Spain.
Health Policy. 2012 Jun;106(1):23-8. doi: 10.1016/j.healthpol.2012.02.001. Epub 2012 Apr 9.
The purpose of this paper is to convey the specific health care actions and policies undertaken by the Spanish government, as well as by regional governments, as a result of the economic crisis. Throughout the last two years we have witnessed a number of actions in areas such as human capital, activity and processes, outsourcing and investment that, poorly coordinated, have shaped the nature of financial cuts on public services. This paper discloses the size and magnitude of these actions, the main actors involved and the major consequences for the health sector, citizens and patients. We further argue that there are a number of factors which have been neglected in the discourse and in the actions undertaken. First, the crisis situation is not being used as an opportunity for major reforms in the health care system. Further, the lay public and professionals have remained as observers in the process, with little to no participation at any point. Moreover, there is a general perception that the solution to the Spanish situation is either the proposed health care cuts or an increase in cost sharing for services which neglects alternative and/or complementary measures. Finally, there is a complete absence of any scientific component in the discourse and in the policies proposed.
本文旨在传达西班牙政府和地区政府因经济危机而采取的具体医疗保健措施和政策。在过去的两年中，我们已经看到了一些在人力资本、活动和流程、外包和投资等领域的行动，这些行动协调不佳，塑造了公共服务财政削减的性质。本文揭示了这些行动的规模和重要性、主要参与者以及对卫生部门、公民和患者的主要影响。我们进一步认为，在论述和所采取的行动中，有一些因素被忽视了。首先，危机局势并没有被用作医疗保健系统重大改革的机会。此外，公众和专业人士在这个过程中一直处于旁观者的地位，几乎没有参与。此外，人们普遍认为，解决西班牙局势的办法要么是削减医疗保健，要么是增加服务费用分担，而忽视了替代和/或补充措施。最后，在论述和提出的政策中完全没有科学成分。
