Las desigualdades en salud y la transformación del sistema sanitario vasco

This article addresses the issue of health inequalities within a broad vision of the future of the health system in the Basque Country and the answers given to existing challenges resulting from the change in the demographic, social and epidemiological profile. For the diagnosis and situation analysis, Basque health has been framed within the Spanish National Health System, whose essential principles it shares. It shows how the impact of the Great Recession on the health of the Basque population has been limited and has undoubtedly multifactorial causes, but the effect of the institutional response to the crisis, characterized by highly priced austerity measures, can´t be ignored. Express policies to compensate for the effect of measures to cut the central government (changes in co-payments and the elimination of health coverage for non-regular immigrants, emphasis on organizational transformation and echnological innovation). From these transformative strategic initiatives, an integrated, patient-centred model has emerged, directed at value creation and with a focus on population health. Preliminary assessments show good results, which has made the Basque public health delivery model an international benchmark.