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Healthcare Report Spain

  • ID: 2866314
  • Report
  • Region: Spain
  • 14 Pages
  • The Economist Intelligence Unit
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Overview

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In nominal local-currency terms, we expect total health expenditure to rise at a compound annual growth rate (CAGR) of 3.9% (or 4.8% in US dollar terms) in 2019-23. This is faster than in the past five years (2014-18), when expenditure growth averaged 2.9% per year. Pharmaceutical sales will register a slightly stronger CAGR of 4.4% in euro terms and 5.4% in US dollar terms, despite continued cost controls. Growth will be driven by market consolidation and wider use of newer medicines.The outlook for healthcare policy is clouded by political uncertainty, however. Pedro Sánchez, of the Spanish Socialist Workers' Party, won the April 28th general election (the third election since December 2015), but with only 29% of the vote. Even assuming that he can negotiate sufficient backing from smaller parties, he will lead a weak centre-left minority government. Parliamentary fragmentation sustains the risk that the current government will not be able to serve out a full four-year term or force through any substantial changes to health policy. Despite strained resources, however, Spain's health indicators remain among the best in the world.Funding sourcesSpain's public health system, the Sistema Nacional de Salud (SNS), is funded almost entirely from general taxation. Public healthcare (except for pharmaceuticals) is free at the point of use for all residents holding social security health cards. In 2012 cards were withdrawn from about 800,000 people, mostly illegal immigrants, amid spending cuts, but the right to primary care for illegal immigrants was reinstated in 2015.Healthcare: key indicators 2014a2015a2016b2017b2018b2019c2020c2021c2022c2023cLife expectancy, average (years)82.382.582.7a82.9a83.0a83.283.483.583.683.8Life expectancy, male (years)79.379.679.8a80.0a80.2a80.480.680.880.981.0Life expectancy, female (years)85.185.385.5a85.6a85.8a85.986.086.286.386.5Infant mortality rate (per 1,000 live births)3.33.3b3.33.33.33.23.23.23.23.2Healthcare spending (€ bn)93.798.6b100.4103.1106.8110.4114.9119.6124.5129.1Healthcare spending (% of GDP)9.09.1b9.08.88.88.98.98.99.09.0Healthcare spending (US$ bn)124.4109.4b111.0116.4126.2125.8136.8144.4154.1159.7Healthcare spending (US$ per head)2,6752,358b2,3962,5122,7202,7092,9443,1083,3203,443Healthcare (consumer expenditure; US$ bn)33.128.629.0a30.8a33.533.636.438.641.343.2Doctors (per 1,000 people)3.83.93.9a3.94.04.04.04.14.14.1Hospital beds (per 1,000 people)3.03.03.03.03.03.03.03.03.03.0a Actual.
b Economist Intelligence Unit estimates.
c Economist Intelligence Unit forecasts.Sources: World Health Organisation; UN; US
Bureau of Census; The Economist Intelligence Unit.Download the numbers in Excel
Government spending accounted for 66.5% of Spain's current expenditure on healthcare in 2016, according to the OECD, with 4.8% coming from social insurance contributions. The total share of compulsory public spending fell from 75.4% in 2009 to 70.8% in 2017, owing to cost-saving measures introduced amid the euro zone financial crisis. Since 2002 responsibility for public healthcare spending and provision has been devolved to regional governments. Spain now has 17 parallel public health services, with different structures and means of delivery. Regional governments have had the option of raising additional taxes to supplement central government health spending since 2001. This led to a large build-up of regional debt during the financial crisis. In mid-2015, amid efforts to reduce these debts, Spain's regions signed a voluntary agreement with the central government to align spending on healthcare equipment and pharmaceuticals with economic growth. However, the central government continues to exert pressure on some regions to control costs, particularly with regard to the separatist movement in Catalonia.Private health insuranceAs public expenditure was reined in, private or voluntary expenditure on healthcare increased from 24.6% of the total in 2009 to 29.2% in 2017, according to OECD estimates. This includes out-of-pocket (OOP) expenditure, the share of total health expenditure of which rose from 19% in 2009 to 25% in 2014 following the introduction of a new co-payment system in 2012. However, the OOP share fell back to 23.8% in 2017 as public spending recovered.Although most private plans are complementary to the public system, Spain's 2.6m civil servants can opt out of the public system and take state-sponsored private health insurance instead. The recession of 2011-13 dented take-up of private plans, but the market has picked up since 2017. Demand for private healthcare will continue to grow in 2019-23, reflecting the easing of economic conditions and the continuing pressure on the public system.Spain's private health insurance sector has been consolidating in recent years. Adeslas and Asisa have a strong client base among civil servants who have opted out of the public health system. Sanitas, which is owned by Bupa (UK), targets companies and individuals as customers.

Spain's healthcare spending was equivalent to 8.8% of GDP in 2017, according to OECD data-slightly below the EU average of 9.9% of GDP. The Economist Intelligence Unit estimates that Spain's ratio remained stable in 2018 but will reach 9% of GDP by the end of the forecast period (2019-23). Spending growth will be driven by moderate economic growth, an ageing population and increased spending on high-cost medicines.

Industry List: Disease trends, Healthcare, Healthcare, Pharmaceuticals and biotechnology, Healthcare, Provision, Healthcare, Spending
Industry Codes (NAIC): 62
Industry Codes (SIC): 80
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Healthcare Report Spain

Healthcare report: Healthcare spending

Healthcare report: Healthcare provision

Healthcare report: Pharma and biotech

Healthcare report: Disease trends
Note: Product cover images may vary from those shown
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