Competition and collaboration between public and private sectors: the historical construction of the Spanish hospital system (1942-1986)
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Competition and collaboration between public and private sectors: the historical construction of the Spanish hospital system (1942-1986)Data
2019Cita bibliográfica
Vilar Rodríguez, M. y Pons Pons, J. (2019). Competition and collaboration between public and private sectors: the historical construction of the Spanish hospital system 1942-86. Economic History Review, 72(4), 1384-1408. https://doi.org/10.1111/ehr.12771
Resumo
[Abstract]: In general, healthcare, along with diet, has historically been an essential component of
life and a country's welfare. In particular, a country’s hospital system is a key indicator
for analysing the level of welfare achieved in health coverage. Its study from an
economic history perspective is relevant since it stems from public and private
investment and produces positive externalities by creating employment and stimulating
other economic sectors such as construction and health. Spain provides a significant
case study for determining the factors of backwardness in a country of the European
periphery which, in the late twentieth century, attained a degree of quality confirmed by
the current international hospital rankings and even by the phenomenon of health
tourism. The study analyses the creation of the Spanish hospital system during the
Franco dictatorship and the transition to democracy. It reveals how the maintenance of a
regressive tax system, the use of health policy as political propaganda and disputes
within the political elite of the dictatorship led to an inadequate and fragmented public
hospital system, which needed to collaborate with the private hospital system and which
was full of financial holes and tainted by corruption, while remaining at the service of
privileged groups.
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ISSN
0013-0117