Competition and collaboration between public and private sectors: the historical construction of the Spanish hospital system, 1942–86

Throughout history, healthcare, along with diet, has been an essential component of life and a country's welfare. In particular, a country's hospital system is a key indicator for analysing the level of welfare achieved by health coverage. From an economic history perspective, the study of hospital systems is relevant since they stem from public and private investment and produce positive externalities by creating employment and stimulating other economic sectors such as construction and health. Spain provides a significant case study for determining the factors of backwardness in the construction of a modern hospital system in a country on the European periphery. Moreover, it also helps us understand how, despite initial obstacles, this system had attained a significant degree of quality by the end of the twentieth century, as confirmed by its current international hospital rankings and even by the phenomenon of health tourism. The study analyses the creation of the Spanish hospital system during Franco's dictatorship and the transition to democracy. It reveals how the maintenance of a regressive tax system, the use of health policy as political propaganda, and disputes within the political elite of the dictatorship led to an inadequate and fragmented public hospital system, which had to collaborate with the private hospital system, was full of financial holes and tainted by corruption, and remained at the service of privileged groups.     

Customers’ Risk Factor Disclosures and Suppliers’ Investment Efficiency

This study examines the effect of downstream firms’ (i.e., customers’) risk factor disclosures contained in annual reports on the investment efficiency of upstream firms (i.e., suppliers). We find that more informative disclosures of customers’ risk factors are associated with less under‐ or overinvestment by suppliers. In addition, this inverse association is stronger when the suppliers are at a bargaining disadvantage, when they operate in the durable goods industries, and when they are more concerned about the volatility of future demand. Overall, our results suggest that risk factor disclosures provided by firms in their annual reports contain useful information that could potentially help their suppliers achieve better investment efficiency. Divulgation d'information sur les facteurs de risque des clients et efficience de l'investissement des fournisseurs     

The rise and fall of Spain (1270–1850)1

Two distinctive regimes are distinguished in Spain over half a millennium. The first one (1270s–1590s) corresponds to a high land–labour ratio frontier economy, which is pastoral, trade‐oriented, and led by towns. Wages and food consumption were relatively high. Sustained per capita growth occurred from the end of the Reconquest (1264) to the Black Death (1340s) and resumed from the 1390s only broken by late fifteenth‐century turmoil. A second regime (1600s–1810s) corresponds to a more agricultural and densely populated low‐wage economy which, although it grew at a pace similar to that of 1270–1600, remained at a lower level. Contrary to pre‐industrial western Europe, Spain achieved its highest living standards in the 1340s, not by mid‐fifteenth century. Although its death toll was lower, the plague had a more damaging impact on Spain and, far from releasing non‐existent demographic pressure, destroyed the equilibrium between scarce population and abundant resources. Pre‐1350 per capita income was reached by the late sixteenth century but only exceeded after 1820.