La descentralización fiscal en España en la disyuntiva de la nueva financiación autonómica: algunas reflexiones generales y específicas al caso de la sanidad

Once central finance of regional health care has been definitively integrated on the whole regional finance, a new perspective is open to health care decentralisation. Regional Parliaments get a definitive say on the day to day of health care management and finance, and the need of intersectorial ba... Deskribapen osoa

Egile nagusia: López Casasnovas, Guillem
Formatua: Artikulua
Hizkuntza: Gaztelania
Argitaratua: Universidad de Almería 2007
Sarrera elektronikoa: http://dialnet.unirioja.es/servlet/oaiart?codigo=2295784
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Laburpena: Once central finance of regional health care has been definitively integrated on the whole regional finance, a new perspective is open to health care decentralisation. Regional Parliaments get a definitive say on the day to day of health care management and finance, and the need of intersectorial balances and local spending and fiscal priorities start to dominate the autonomous political agenda. The former approach, based on much of central 'spending power' seems finally dead and the aim to define centrally parameterised 'regional needs' is not anymore at the central core of the political debate. Now it is time for health policies to adequate initially centrally defined finance with regional final expenditure by raising own taxes, improve regional health expenditure and promote better prevention policies, since no more revenues can be raised by claiming regional spending overruns. The equity debate is then limited to the central plafond (here with population changes and migration representing still further refinements to be made) and the 'within' disparities in health should be the main concern on internal regional policies. This makes for a substantial change, according to the author's perspective, that requires accommodating the research agenda to this new situation for the near future.