Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.

A delphy study of the cooperativisation of the social services in the historical territory of Gipuzkoa

This article shows the main results obtained from the Delphi study, which was made of politicians and technicians from the Department of Social Policy in the County Council of Gipuzkoa, concerning the possibility of cooperativizing the provision of social services in this historical territory. With this in mind, the structure of this article is in two different parts. The first part develops the theoretical framework which serves as inspiration for the empirical work, where note is made of the main theoretical proposals that have a bearing on the collective dimension of citizen participation in the management of public services. Among the various models, those which prioritise public participation through social and solidarity economy entities stand out. The second part concerns itself with the presentation of the field research results. To this end, the methodological notes concerning the preparation process for the Delphi analysis are presented first and this is immediately followed by a synthesis of the main results obtained in this study. The article ends with a section of conclusions and future lines of action.