Sustainability of the Public Health Service in Spain: an Approach to Governance

The health system sustainability is a key topic in Spain’s political debates. What a sustainable heath system should be poses a big concern for citizens and politicians. Foremost for managers and political actors, to ascertain the right way to build a good mid- and large-term finan cial model of sustainability is critical as well. However, to link exclusively the financial sustainability of the health system with a political objective could be a limited overview. Issues that affect the national health system have an impact on the entire society and its processes and activities result in environmental externalities. The analysis focuses on the triple bottom line: economic, social and environmental; displaying a wider view of the Spanish health models and their future strategies. Likewise, it needs to be understood whether the concept of sustainability goes beyond the economical concerns in the plans of the health authority and their financial budgets, and come to terms with the expectations of citizens and the political speech, considering that the health budgets of Spain and other OECD countries show a weakness point in this regard. This article analyzes the challenges of the health system and its critical points from the perspective of the health authority.