Issues raised by the impact of tax reforms and regional devolution on health-care financing in Spain, 1996 - 2002

The authors aim to describe and discuss the likely effects of three recent policy measures related to the financing of the Spanish National Health System which have been introduced over the period 1996 - 2002 under the conservative Popular Party government. First, tax incentives for private health insurance were introduced with the 1999 income tax reform. Second, in 2002 the devolution of health-services management to regional governments was completed along with reform of the regional mechanism of allocation of public funds (intergovernmental grants, tax revenues, and fiscal accountability). Third, earmarked indirect taxes were introduced in 2002 as a source of additional revenues devoted to public-health financing.