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Do individuals’ health preferences validate the decentralisation of the public health system in Spain?

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  • Sigüenza, Waleska
  • Artabe, Alaitz

Abstract

The objective of this paper is to estimate individuals’ preferences about public health services in two Spanish regions, the Basque Country (BC) and Canary Islands (CI) and analyse whether they differ. This work was motivated by the actual economic situation, where it is necessary to obtain equilibrium between the needed health services and limited economic resources. With this limitation in mind, politicians have tried to design health policies that maximise individuals’ welfare. Based on the theory of decentralisation, the devolution of public expenditure decisions and management to regional government maximises individuals’ welfare more when individual preferences differ among regions. A discrete choice experiment was implemented with a survey designed to obtain data about individuals’ choices. Using this data and discrete choice models, individual preferences for health services were estimated. Our findings indicate that these preferences differ among regions, so, for reasons of efficiency, decentralising decisions and management of public health policies to regional governments would be recommended. Once health policies are decentralised, our results provide a tool for identifying the health services most valued by the individuals in each region. This information would be useful policymakers designing health policies.

Suggested Citation

  • Sigüenza, Waleska & Artabe, Alaitz, 2022. "Do individuals’ health preferences validate the decentralisation of the public health system in Spain?," Health Policy, Elsevier, vol. 126(7), pages 680-687.
    • Handle: RePEc:eee:hepoli:v:126:y:2022:i:7:p:680-687
    DOI: 10.1016/j.healthpol.2022.04.010
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    References listed on IDEAS

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    1. Waleska Sigüernza & Petr Mariel, 2013. "Valoración económica de los servicios sanitarios en la Comunidad Autónoma del País Vasco," Hacienda Pública Española / Review of Public Economics, IEF, vol. 207(4), pages 71-99, December.
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    4. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, November.
    5. Wallace E. Oates & Wallace E. Oates, 2004. "An Essay on Fiscal Federalism," Chapters, in: Environmental Policy and Fiscal Federalism, chapter 22, pages 384-414, Edward Elgar Publishing.
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    7. Alaitz Artabe & Waleska Sigüenza, 2019. "The effects of the economic recession on spending on private health insurance in Spain," International Journal of Health Economics and Management, Springer, vol. 19(2), pages 155-191, June.
    8. Gregory L. Poe & Kelly L. Giraud & John B. Loomis, 2005. "Computational Methods for Measuring the Difference of Empirical Distributions," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 87(2), pages 353-365.
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