El seguro de salud privado y público en España: su análisis en perspectiva histórica
In: Ciencias Sociales 108
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In: Ciencias Sociales 108
In: El Tall del temps 24
Los cambios institucionales iniciados con la aprobación de la ley de accidentes de trabajo de 1900 y las normas posteriores en este ámbito, provocaron cambios sustanciales en el mercado español de seguros. Se creó un nuevo ramo, surgieron compañías especializadas y empezaron a operar compañías de seguros de accidentes extranjeras en España. En este artículo, a través de la evolución de primas y compañías, se analiza el seguro de accidentes de trabajo desde sus inicios hasta la década de 1940, cuando se convierte en el ramo de mayor volumen. Finalmente, se estudia cómo, desde su creación, algunos empresarios comprendieron la necesidad de participar en el negocio y, en ocasiones, aliados con los empresarios del seguro, constituyeron compañías especializadas. Este interés se acrecentó con la obligatoriedad del seguro durante la II República, hecho que provocó un aumento de la competencia entre mutuas patronales y compañías de seguros. ; The institutional changes which took place with the law of industrial accidents of 1900 and the later regulations caused substantial changes in the Spanish insurance market. A new insurance field was created in which both specialist Spanish companies and foreign insurance agencies operated. This article aims to analyse the evolution of this new field, industrial accident insurance, from its beginning to the 1940s, when it become the most important insurance category. For that purpose premiums and companies have been reconstructed. It is observed too how from the start some industrialists understood the necessity to participate in this business and therefore they sometimes allied with insurance businessmen to form specialist companies. The interest in industrial accidents insurance increased during the 2nd Republic due to government's obligatory insurance requirements, what originated an uprising competition between mutual employer's associations and insurance agencies.
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In: Ciencias sociales 74
In: Revista de historia económica: RHE = Journal of Iberian and Latin American economic history, Band 42, Heft 2, S. 217-242
ISSN: 2041-3335
AbstractSickness insurance companies were developed in Spain by doctors and healthcare professionals, remaining outside the interests of general insurance companies. Their management was hardly professional, with limited actuarial techniques and they only accounted for a small percentage of total insurance business premiums. From the 1970s onwards, various factors changed this situation, driving processes of concentration, with numerous takeovers and mergers, first reducing the number of local and regional companies to the benefit of companies of national scope. Subsequently, the growth in demand for this type of coverage sparked the interest of national general insurance companies and multinationals, leading to a restructuring of the sector which has progressively acquired greater weight within the insurance business and become increasingly internationalised. This last stage immersed the health sector in Spain in the great processes of globalisation of the sector, characterised by a financialisation of capital promoted by the bank investment funds. These processes are little known and are the focus of analysis of this paper, with the aim of enabling comparison at international level.
In: Social history, Band 49, Heft 1, S. 1-25
ISSN: 1470-1200
In: Business history, Band 66, Heft 2, S. 510-528
ISSN: 1743-7938
In: Enterprise & society: the international journal of business history, Band 23, Heft 3, S. 599-639
ISSN: 1467-2235
This article discusses the role of employers and their organizations in promoting or hindering social insurance schemes and, ultimately, the welfare state. Unlike most studies that center on countries in periods of democracy, this research focuses on the role of employers, and specifically employers' mutuals, in the development of the industrial accident scheme during the Franco dictatorship in Spain. The institutional elimination of the class struggle, by repressing the working class and prohibiting class-based unions, led to an evolution of the industrial accident scheme and employers' liabilities that revolved around the interrelationship between employers and the state. While employers tried to keep control of the management and low cost of the insurance, the state maintained significant bureaucratic intervention and increased auditing and control. The democratic period that began in 1977 prolonged the structure fostered during the Franco regime and enhanced the power of the mutuals in managing this insurance.
[Abstract]: This paper analyses the roots of the creation of the Catalan hospital model, based on a preponderance of privately owned hospitals and beds over those of public provision. In particular, on the basis of new statistical and documentary sources and a review of the existing historiography, this study reinterprets the keys that shaped this historical model during what is considered to be a strategic period of the process, 1870-1935. In the late nineteenth century, hospitals dependent on provincial authorities became private charity institutions in the provincial capitals, under the control of the medical and economic elites (a decisive process in the case of the city of Barcelona). Later, during the dictatorship of Primo de Rivera and the Second Republic, institutional impetus helped foster a system of district hospitals intended to meet the public demand for a network of public utility hospitals. This network was made up the few publicly owned hospitals and numerous privately owned ones. The philosophy of this model was taken up again during the transition to democracy after responsibility for healthcare was devolved to the Government of Catalonia 1981.
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This paper analyses the roots of the creation of the Catalan hospital model, based on a preponderance of privately owned hospitals and beds over those of public provision. In particular, on the basis of new statistical and documentary sources and a review of the existing historiography, this study reinterprets the keys that shaped this historical model during what is considered to be a strategic period of the process, 1870-1935. In the late nineteenth century, hospitals dependent on provincial authorities became private charity institutions in the provincial capitals, under the control of the medical and economic elites (a decisive process in the case of the city of Barcelona). Later, during the dictatorship of Primo de Rivera and the Second Republic, institutional impetus helped foster a system of district hospitals intended to meet the public demand for a network of public utility hospitals. This network was made up the few publicly owned hospitals and numerous privately owned ones. The philosophy of this model was taken up again during the transition to democracy after responsibility for healthcare was devolved to the Government of Catalonia 1981.
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Los hospitales municipales y provinciales representaron un papel clave en la configuración histórica del sistema hospitalario en España hasta la segunda mitad del siglo XX. Su papel estratégico en la beneficencia del siglo XIX para la cobertura de los pobres se modificó con el avance y la configuración del hospital moderno ubicado en nuevos edificios y técnicas de gestión, con una estructura interna jerarquizada y avances en ámbito diagnóstico-terapéutico para la cobertura de cada vez más porcentaje de población. Partiendo de esta idea, este trabajo se centra en el estudio histórico de las infraestructuras hospitalarias públicas vinculadas a los municipios y diputaciones en España con dos objetivos. De un lado, trata de analizar cómo se configuraron, qué servicios prestaron y cómo afrontaron su financiación hasta la dictadura de Franco. De otro, aborda los efectos que tuvo la puesta en marcha del Seguro Obligatorio de Enfermedad (SOE), en 1944, y la construcción de su propia red de hospitales, conocidos como residencias sanitarias, en el funcionamiento y supervivencia de estas viejas infraestructuras municipales y provinciales. Finalmente se analiza su práctica desaparición tras la cesión de las competencias sanitarias en la transición democrática. ; Municipal and provincial hospitals played a key role in the historical creation of the hospital system in Spain until the second half of the 20th century. Their strategic role in coverage of the poor under the 19th century charity system gradually changed with the creation of the modern hospital, located in new buildings and with innovative management techniques, which had a hierarchical internal structure and implemented advances in the diagnostic and therapeutic field. These helped to provide coverage to an increasingly large segment of thepopulation. With this background, this paper focuses on a historical study of the public hospital structures linked to municipalities and provincial councils with specific objectives. First, it analyses how they were set up and organized, the services they provided, and how they were financed up to the Franco dictatorship. Second, it examines how the functioning and survival of the old municipal and provincial infrastructures were affected by the implementation of compulsory sickness insurance in 1944 and the construction of an accompanying network of hospitals known as «residencias sanitarias», Finally, it analyses their practical disappearance after the transfer of responsibility for health care during the transition to democracy.
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Los hospitales municipales y provinciales representaron un papel clave en la configuración histórica del sistema hospitalario en España hasta la segunda mitad del siglo XX. Su papel estratégico en la beneficencia del siglo XIX para la cobertura de los pobres se modificó con el avance y la configuración del hospital moderno ubicado en nuevos edificios y técnicas de gestión, con una estructura interna jerarquizada y avances en ámbito diagnóstico-terapéutico para la cobertura de cada vez más porcentaje de población. Partiendo de esta idea, este trabajo se centra en el estudio histórico de las infraestructuras hospitalarias públicas vinculadas a los municipios y diputaciones en España con dos objetivos. De un lado, trata de analizar cómo se configuraron, qué servicios prestaron y cómo afrontaron su financiación hasta la dictadura de Franco. De otro, aborda los efectos que tuvo la puesta en marcha del Seguro Obligatorio de Enfermedad (SOE), en 1944, y la construcción de su propia red de hospitales, conocidos como residencias sanitarias, en el funcionamiento y supervivencia de estas viejas infraestructuras municipales y provinciales. Finalmente se analiza su práctica desaparición tras la cesión de las competencias sanitarias en la transición democrática. ; Municipal and provincial hospitals played a key role in the historical creation of the hospital system in Spain until the second half of the 20th century. Their strategic role in coverage of the poor under the 19th century charity system gradually changed with the creation of the modern hospital, located in new buildings and with innovative management techniques, which had a hierarchical internal structure and implemented advances in the diagnostic and therapeutic field. These helped to provide coverage to an increasingly large segment of the population. With this background, this paper focuses on a historical study of the public hospital structures linked to municipalities and provincial councils with specific objectives. First, it analyses how they were set up and organized, the services they provided, and how they were financed up to the Franco dictatorship. Second, it examines how the functioning and survival of the old municipal and provincial infrastructures were affected by the implementation of compulsory sickness insurance in 1944 and the construction of an accompanying network of hospitals known as "residencias sanitarias", Finally, it analyses their practical disappearance after the transfer of responsibility for health care during the transition to democracy.
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Este trabajo forma parte del proyecto titulado «Las claves históricas del desarrollo hospitalario en España y su comparación internacional durante el siglo XX» (referencia: RTI2018-094676-B-I00), financiado por FEDER y el Ministerio de Ciencia e Innovación/Agencia Estatal de Investigación. ; En conjunto, en estos cinco trabajos tejidos desde un enfoque multidisciplinar encontramos diferentes análisis sobre el desarrollo del sistema hospitalario en España que nos permiten entender su complejidad y diversidad. Estos diferentes tipos de hospitales cumplieron funciones diversas según la etapa histórica y el territorio analizado y tuvieron diferente suerte en su adaptación al proceso de modernización de la atención hospitalaria y en su capacidad para afrontar la competencia del sistema público hospitalario y las compañías privadas. Además, estas aportaciones nos permiten completar algunos de los factores determinantes de este proceso histórico y señalar las diferencias y similitudes del caso español con otros países de nuestro entorno. Son todos los que están, pero no están todos los que son; somos conscientes de las lagunas. El dossier no incluye ningún estudio sobre los hospitales benéficos privados, las conocidas como residencias sanitarias de la Seguridad Social, hospitales militares o los hospitales religiosos, entre otros. Sobre las tres últimas tipologías contamos con estudios bastante completos de publicación reciente 26; sobre el estudio en el largo plazo de los hospitales benéficos privados, creemos que la historiografía tiene una deuda pendiente que algún día deseamos cubrir. Inmersos en una pandemia, somos conscientes de la importancia de nuestro sistema hospitalario del que dependen cada día muchas vidas. ; RTI2018-094676-B-I00 FEDER y el Ministerio de Ciencia e Innovación/Agencia Estatal de Investigación
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