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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La tendencia del gasto social a distribuirse hacia las edades m&#225;s avanzadas se ha advertido en varios pa&#237;ses desarrollados&#46; Mientras el envejecimiento de la poblaci&#243;n es una tendencia com&#250;n&#44; no es obvio por qu&#233; el cambio en los gastos excede a la propia evoluci&#243;n del envejecimiento&#44; o por qu&#233; el gasto aumenta en t&#233;rminos por c&#225;pita&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En la primera parte del art&#237;culo mostramos que hay indicios claros de esta tendencia en Espa&#241;a&#44; identificamos a los colectivos perjudicados&#44; abordamos las pol&#237;ticas que afectan a esta tendencia&#44; y proponemos ajustes basados en la regla de proporciones fija de Musgrave para una distribuci&#243;n intergeneracional m&#225;s justa&#46; Son las pol&#237;ticas relacionadas con el envejecimiento poblacional&#44; con la inserci&#243;n laboral de j&#243;venes y mujeres&#44; y las estrategias del <span class="elsevierStyleItalic">work-fare</span>&#44; junto con las m&#225;s tradicionales del <span class="elsevierStyleItalic">welfare</span>&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En la segunda parte insertamos el gasto sanitario p&#250;blico en el conjunto del gasto social&#46; Adoptamos la perspectiva de que las pol&#237;ticas sanitaria y social deber&#237;an ser m&#225;s horizontales&#44; menos dependientes del formato de financiaci&#243;n&#44; y coordinadas con visi&#243;n intersectorial en su destino e interdepartamental en su origen&#46; El criterio normativo de equidad pretendido debe ser expl&#237;cito y preciso&#46; Las pol&#237;ticas deben asegurar coherencia entre los distintos tipos de prestaciones p&#250;blicas&#44; y determinar la cuant&#237;a de componentes de bienestar adicionales a los derivados de la renta personal&#44; para compensar su desigualdad mediante prestaciones p&#250;blicas monetarias o en especie&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En Espa&#241;a &#40;1980-2000&#41;&#44; el grupo de edad m&#225;s avanzada ha sido el que ha obtenido unas mayores ganancias&#44; &#171;acaparando &#187; una mayor proporci&#243;n de recursos&#44; que han aumentado m&#225;s all&#225; de lo que podr&#237;a explicarse solamente por el envejecimiento de la poblaci&#243;n&#46; Los &#171;perdedores&#187; son individuos en diversas condiciones de fragilidad y&#44; en t&#233;rminos medios&#44; la generaci&#243;n de trabajadores m&#225;s joven es la categor&#237;a de edad que ha sufrido las mayores p&#233;rdidas relativas&#46;</p>"
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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The tendency for public welfare spending to be increasingly aimed at the elderly has been identified in several developed countries&#46; While population aging is a common trend&#44; it is not obvious why the shift in spending exceeds the trend in aging&#44; or why <span class="elsevierStyleItalic">per capita</span> spending on the elderly is increasing&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">In the first part of the present article&#44; we show that this trend is occurring in Spain&#44; identify the losers from this development&#44; discuss the policies that underlie it&#44; and propose adjustments based on Musgrave&#39;s fixed proportions rule for fair intergenerational distribution&#46; These policies aim to manage population aging&#44; labor market participation of youth and women&#44; as well as public policies that combine &#8216;work-fare&#8217; strategies with the more traditional &#8216;welfare&#8217; strategies&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">In the second part of this paper&#44; we explore the contribution of public health expenditure to overall public social expenditure&#44; and analyze the effect of increasing health on distributional fairness&#46; This analysis is guided by our perception that social policy&#44; including health policy&#44; should be more horizontal&#44; i&#46;e&#46; it should take into account the sum total of a mixed basket of resources aimed at any recipient group&#44; to avoid the skewed allocation of resources that arises from compounding various independent distributions of resources&#46; Coordination of the various channels of social expenditure should ensure precisely targeted recipients and cross-departmental sources&#46; The normative fairness criterion to be used should be precisely specified&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">In Spain &#40;1980-2000&#41; the oldest segment of the population has gained the most&#44; appropriating an increased share of resources&#46; This increase goes beyond the amount that could be explained by population aging throughout the period&#46; The &#8216;losers&#8217; are individuals with different fragility conditions&#46; On average the youngest working group has suffered the highest relative loss&#46;</p>"
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Capítulo 2. Políticas de salud pública
El gasto sanitario en el contexto del gasto social. Un análisis generacional de las tendencias en España en un contexto de envejecimiento demográfico. Informe SESPAS 2008
Health expenditure in the context of social expenditure. A generational analysis of tendencies in Spain in the context of demographic aging
Guillem López Casasnovas
,1
, Ana Mosterín Höpping
Universidad Pompeu Fabra y CRES, Barcelona, España
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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La tendencia del gasto social a distribuirse hacia las edades m&#225;s avanzadas se ha advertido en varios pa&#237;ses desarrollados&#46; Mientras el envejecimiento de la poblaci&#243;n es una tendencia com&#250;n&#44; no es obvio por qu&#233; el cambio en los gastos excede a la propia evoluci&#243;n del envejecimiento&#44; o por qu&#233; el gasto aumenta en t&#233;rminos por c&#225;pita&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En la primera parte del art&#237;culo mostramos que hay indicios claros de esta tendencia en Espa&#241;a&#44; identificamos a los colectivos perjudicados&#44; abordamos las pol&#237;ticas que afectan a esta tendencia&#44; y proponemos ajustes basados en la regla de proporciones fija de Musgrave para una distribuci&#243;n intergeneracional m&#225;s justa&#46; Son las pol&#237;ticas relacionadas con el envejecimiento poblacional&#44; con la inserci&#243;n laboral de j&#243;venes y mujeres&#44; y las estrategias del <span class="elsevierStyleItalic">work-fare</span>&#44; junto con las m&#225;s tradicionales del <span class="elsevierStyleItalic">welfare</span>&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En la segunda parte insertamos el gasto sanitario p&#250;blico en el conjunto del gasto social&#46; Adoptamos la perspectiva de que las pol&#237;ticas sanitaria y social deber&#237;an ser m&#225;s horizontales&#44; menos dependientes del formato de financiaci&#243;n&#44; y coordinadas con visi&#243;n intersectorial en su destino e interdepartamental en su origen&#46; El criterio normativo de equidad pretendido debe ser expl&#237;cito y preciso&#46; Las pol&#237;ticas deben asegurar coherencia entre los distintos tipos de prestaciones p&#250;blicas&#44; y determinar la cuant&#237;a de componentes de bienestar adicionales a los derivados de la renta personal&#44; para compensar su desigualdad mediante prestaciones p&#250;blicas monetarias o en especie&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">En Espa&#241;a &#40;1980-2000&#41;&#44; el grupo de edad m&#225;s avanzada ha sido el que ha obtenido unas mayores ganancias&#44; &#171;acaparando &#187; una mayor proporci&#243;n de recursos&#44; que han aumentado m&#225;s all&#225; de lo que podr&#237;a explicarse solamente por el envejecimiento de la poblaci&#243;n&#46; Los &#171;perdedores&#187; son individuos en diversas condiciones de fragilidad y&#44; en t&#233;rminos medios&#44; la generaci&#243;n de trabajadores m&#225;s joven es la categor&#237;a de edad que ha sufrido las mayores p&#233;rdidas relativas&#46;</p>"
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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The tendency for public welfare spending to be increasingly aimed at the elderly has been identified in several developed countries&#46; While population aging is a common trend&#44; it is not obvious why the shift in spending exceeds the trend in aging&#44; or why <span class="elsevierStyleItalic">per capita</span> spending on the elderly is increasing&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">In the first part of the present article&#44; we show that this trend is occurring in Spain&#44; identify the losers from this development&#44; discuss the policies that underlie it&#44; and propose adjustments based on Musgrave&#39;s fixed proportions rule for fair intergenerational distribution&#46; These policies aim to manage population aging&#44; labor market participation of youth and women&#44; as well as public policies that combine &#8216;work-fare&#8217; strategies with the more traditional &#8216;welfare&#8217; strategies&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">In the second part of this paper&#44; we explore the contribution of public health expenditure to overall public social expenditure&#44; and analyze the effect of increasing health on distributional fairness&#46; This analysis is guided by our perception that social policy&#44; including health policy&#44; should be more horizontal&#44; i&#46;e&#46; it should take into account the sum total of a mixed basket of resources aimed at any recipient group&#44; to avoid the skewed allocation of resources that arises from compounding various independent distributions of resources&#46; Coordination of the various channels of social expenditure should ensure precisely targeted recipients and cross-departmental sources&#46; The normative fairness criterion to be used should be precisely specified&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">In Spain &#40;1980-2000&#41; the oldest segment of the population has gained the most&#44; appropriating an increased share of resources&#46; This increase goes beyond the amount that could be explained by population aging throughout the period&#46; The &#8216;losers&#8217; are individuals with different fragility conditions&#46; On average the youngest working group has suffered the highest relative loss&#46;</p>"
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Información del artículo
ISSN: 02139111
Idioma original: Español
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