The budget deficit is not specific to health but of all the public services of the Government Administration. The main problem of regional finances, beyond chronic ill treatment and violation of obligations of the State, is the drastic fall of regional tax revenues, which fall not yet know how long that will predictably but we can not expect to return to pre-crisis levels until they past several years. The
billion that they say lacks the Department of Health are the visible result of financial budgets so chronic that have been well below the structural needs of the Catalan health and poor treatment of a financing system that has not recognized a very strong demographic momentum and unequal communities, both as regards aging as a welcome of immigrants in the last ten years. That
Health budget for 2010 did not fulfill the actual expenditure in 2009 has been publicly acknowledged by the new government. This does not solve the budgetary problem of the Catalan government, but it should serve to understand that it is not appropriate economic criteria to steal health just because there is no money. Steal where there is more money without taking into account the results and efficiency of public services can grinds out expensive and can cost many more years of life that should cost.
In any case, can not be avoided even a day plus diet also need health care, but there is little fat when to reduce public spending per person is lower than the average of other communities. To give two examples: public health spending per Catalan equivalent to two thirds of the La Rioja and is 15% lower than that of Cantabria. The budget cuts spending programs to be shared among the Government can not be equal for all services or indiscriminate. Healthcare should not be far shielded the cut but there is no reason not to apply the rule of proportionality.
be cut more services that get very poor results (effectiveness) and those that provide less value in relation to that cost (efficiency). In this context, intelligent politician and quality that you know will distribute between cutting public services by making explicit and convincing their constituents about what services are and what less priority. To perform a cut uniform and indiscriminate not simple but we need politicians willing to administrators pruning all the buds. The good gardener is not cut all the shoots of herbs and plants that spring brings us to the same size without distinguishing plants that want to flourish in your garden of herbs and useless opportunists.
not be forgotten that health is the most valued public service and taxpayers who believe that further justifies the taxes they pay. Comparatively it is a fairly efficient and valued public service. Now, having said that, the impact on quality of care and health depends more on the way than just cut the size of the cut.
If you wanted to reduce resources that have the smallest possible impact on social welfare should urgently to avoid cuts to all services and all public hospitals and health centers and for equal indiscriminately. Should share the cost of adjustment, a euphemism for not talking openly reduction of money, cutting public services and also those suppliers inefficient and a worse relationship between their results and resources used, ie the most expensive.
We should try not to reward inefficiency: we can not punish nine hospitals and health centers have done their homework, they have already made efforts to have better results in less health spending, programs that have integrated between primary and hospital care for chronic patients have better controlled and most frequently, they have made efforts to make prescription from their physicians to be more rational and evidence-based, etc.. Must move a greater burden of adjustment to those who do activitats més amb menys positiu impacts on salut. If ho fem aixi, farem més amb menys.
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