La prestación sanitaria en el Estado autonómico: las incongruencias entre el modelo competencial y su financiación

Abstract

The Spanish Constitution reserved to the central legislative power the competence to establish the minimum fundamental services in health (art. 149.1.16 CE), while the Autonomous Communities are the competent ones for their legislative development and management. During these more than forty years of validity of the constitutional text there has been a progressive decentralization in health management, which would culminate in 2001, along with an important legislative centralization. This competence distribution contrasts with the financing system designed for healthcare provision since 2001. A system in which the weight of the responsibility for spending rests primarily with the Autonomous Communities. This paper analyzes the competency distribution in Spain in health matters and relates it to the financing system designed, showing the inconsistency that exists in this regard in the design of health care.