The growth in health spending actually executed in Catalonia last year was the lowest since 2016. It increased by 2.9%, to 14,056.2 million. It is an increase figure of less than the 4.3% estimated by the previous team of the Department of Economy led by Jaume Giró when he presented the 2022 budgets in the fall of 2021.
The slowdown in the growth of real spending (merited) is a consequence of the lesser impact of the covid in the system. In fact, if the evolution of ordinary health spending is analyzed without taking into account that related to the pandemic in either of the two years, the growth is much higher: 9.7% year-on-year between 2021 and 2022.
Sources from the Department of Economy headed by Natàlia Mas explain that the growth in non-covid health spending is mainly a consequence of the recovery in the pace of diagnostic tests and ordinary activity once the impact of the pandemic has been decreasing.
The Health area is the only one in the Generalitat that has unlimited spending. For this reason, in that department the forecast contemplated in the budgets is never met. In the 2022 accounts, for example, it was expected to spend more than 11,000 million and in the end the bill exceeded 14,000 million. The expected growth is also very different from the real one because the previous year was equally higher. Giró's budgets estimated an increase in health spending of 15% and the merit of the aforementioned 4.3%. The merited expense is the one that has actually been executed. Not the expected. That is why it is also very difficult to make estimates.
The Department of Economy defines merited spending as the "actual cost of the budgeted year as a consequence of the activity carried out regardless of the moment in which it is carried out". In this way, it was possible to assess "the volume of services that are being provided at any given time".
The invoice paid last year is the highest in the historical series, as can be seen in the graph. It always tends to be like this, that each year is a record. Only during the financial crisis was this rule not met and for several years less was spent than the previous year. Those were the years of the “retallades”. Such was the impact of the crisis on public accounts that it took the Generalitat a decade to recover the level of health spending prior to those cuts. The 14,056 million last year are more than double what was executed in 2003 and 2004.
As a consequence of the covid, the health sector was especially stressed in the years 2020, 2021 and 2022. This extraordinary situation led to increases never seen before. The first year the growth was 19.5%, in 2021 it was 4% and in 2022 it was 2.9%.
The increases are very different if only “normal” health spending is taken into account without the specific one due to covid. In that case, spending increased by 1.9% in 2020, 7.4% in 2021 and 9.7% last year. That strong increase in spending (without covid) last year, however, remains below the rise in the years before the bubble (between 2006 and 2008) when they were more than 10%.
Last year, the covid took 848.1 million, which means that they are 6 out of every 100 euros of those spent last year. For the current year, the budgets contemplate a health endowment of 11,636 million, which means 9.6% more.
The item is less than what was spent last year. That is why it is expected that the actual (merited) spending for another year will be higher than that approved in the budgets. During the presentation of the public accounts for this year, Natàlia Mas's team declined to estimate the increase in merited spending.
