Health systems II

11 important questions on Health systems II

What is the Compulsory Health Insurance (SOE)?

A compulsory health insurance which covered, in its origins, general medical services, some surgical specialities and pharmaceutical dispensing

What was the exclusive source of financing of Social Security benefits?

The contributions of employers and workers

What happened in 1974 Financial law in the Spanish health care system?

Increased involvement of the state
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What happened in 1977 Pactos Moncloa in the spanish health care system?

Re-structuring of management bodies, decentralization

What happened in 1978?

Spanish constitution
health protection

What happened in 1986? Ley General de Sanidad

Acknowledge rights, decentralization, NHS, health areas, organization levels (central, regional, local), coordination, finance (taxes), drugs, training, research

What are 6 competencies of central government?

- propose and implement government guidelines on health policy, planning and healthcare
- cross border health activities (surveillance and control of health risks derived from import, export and international passenger traffic)
- legislation on pharmaceutical products and their production processes
- high inspection (guarantee and verify the fulfillment of the competences of the state and of the autonomous communities in matters of health)
- health research (ISCIII)
- coordination (interterritorial council of the SNS) and system performance monitoring (CNM, CNE)

What are the competencies of the local administration?

- participate in the management and control of health areas
- competencies in health matters:
  • control of the effects of the environment on the health of individuals, pollution, water, urban and industrial waste, noise and vibration
  • control of buildings and public places: food center, sports areas, schools, etc.
  • control of the food and beverage distribution chain
  • cementeries control 

What kind of benefit packages are there in the NHS? (1-3,1)

Common packages:
- basic
- supplementary (user copayments)
- accesory (100% user payment)
CCAA: already existing (C&Q law 16/2003)

What is the definition of decentralization and health care?

Transfer of authority, or dispersion of power in planning, management and public decision making from national to sub-national level
  • functional (which competencies and policy areas)
  • geographic (territory)

Describe the Catalan health model (1-5,1-4)

Purchaser:
- insurer
- regulation
- health and services plans
- allocate resources
- tenders (contracting out)

provider:
- strategic and operative planning
- motivation of HHRR
- clinical management
- human resources management

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