[The Spanish economic crisis and its consequences on social spending. SESPAS report 2014]

This article offers a brief summary of the factors that the author believes should be considered when analyzing the multiple interrelations between the economic crisis and its effects on public finances, social spending, and the health and welfare of Spaniards. For the sake of brevity, a linear argument is followed, with the basic contents of the message, leaving some of the more controversial issues whose interpretation may be heavily influenced by ideology to the discussion. The core of the argument is that, despite the double dip of the Spanish recession, healthcare has survived the consequences of the crisis fairly well. This is particularly the case when the situation is analyzed in terms of the share of public expenditure to GDP and in per capita terms, given the evolution of these ratios, although the final effect is unknown in terms of the actual and potential beneficiaries. This relatively low incidence so far on the health of Spaniards is basically due to family networks, pooling their incomes, and to the acceptance by Spanish health professionals of budget cuts, which have allowed services and their apparent quality to be maintained, contrasting with private employment and public finances. Obviously, this is not a guarantee of sustainability unless economic growth recovers. Even if the Spanish economy and public finances improve, the composition of health care delivery needs to be reevaluated to achieve a new allocation between public and private responsibilities for healthcare in accordance with the social development of the 21st century.