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Background: A large part of the long-term care is provided by non-professional caregivers, generally without any monetary payment but a value economic of time invested. The economic relevance of informal caregivers has been recognized in Spain; however, public provision may still be scarce. The objective of this paper is to estimate the economic burden associated with informal long-term care that should assume the families through a new concept of cost sharing that consider opportunity costs of time provided by informal caregivers. Methods: The study sample includes all dependent adults in Spain. Socioeconomic information and the number of hours of informal care was collected through the Spanish Disability and Dependency Survey. The terms of shadow and extended shadow cost sharing were defined as the difference between the maximum potential amount of money that families could receive for the provision of informal care and the amount that actually they received and the value of informal care time with respect to the amount received, respectively. Results: 53.87% of dependent persons received an economic benefit associated to informal care. The average weekly hours of care were 71.59 (92.62 without time restrictions). Shadow cost sharing amounted to, on average, two thirds, whereas the State financed the remaining third. In terms of extended shadow cost sharing, the State financed between 3% and 10% of informal care provided by caregivers. Conclusions: This study reveals the deficient support received for the provision of informal care in Spain. More than 90% of informal care time is not covered by the economic benefits that families receive from the State. [ABSTRACT FROM AUTHOR]

Tax benefits targeted to low-wage workers have become very common transfer programs that seek to meet both efficiency and equity targets. An expanding literature has assessed the effects of these policies on income distribution and labor supply showing important implications for female labor participation. In this paper, we estimate the distributional and behavioral impacts of a simulated new benefit in Spain based on the replacement of the existing working mother tax credit (WMTC) using as a reference the US Earned Income Tax Credit (EITC). We simulate the effects of the proposed scheme using EUROMOD and a discrete choice model of labor supply. Our results show that the enhancement of the proposed reform would have significant and positive effects both in terms of female labor participation and inequality and poverty reduction. The introduction of this benefit would generate a substantial increase in labor participation at the extensive margin and a non-negligible reduction at the intensive margin. [ABSTRACT FROM AUTHOR]

Informal care is a substantial source of support for people with cancer. However, various studies have predicted its disappearance in the near future. The aim of this study is to analyse the catastrophic effect resulting from the substitution of informal care with formal care in patients with blood cancer throughout the different stages of treatment. A total of 139 haematological neoplasm patients who underwent stem cell transplantation in Spain, completed a longitudinal questionnaire according to the three phases of treatment between 2012 and 2013. The economic value of informal care was estimated using proxy good, opportunity cost, and contingent valuation methods. Catastrophic health expenditure measures with thresholds ranging from 5 to 100% were used to value the financial burden derived from substitution. A total of 88.5% of patients reported having received informal care. In 85.37%, 80.49%, and 33.33% of households, more than 40% of their monthly income would have to be devoted to the replacement with formal care, with monthly amounts of €2105.22, €1790.86, and €1221.94 added to the 40% in the short, medium, and long-term, respectively (proxy good method, value = 9 €/h). Informal caregivers are a structural support for patients with blood cancer, assuming significant care time and societal costs. The substitution of informal care with formal care would be financially unaffordable by the families of people with blood cancer. [ABSTRACT FROM AUTHOR]

This paper analyzes the effect of private supplementary pensions (and the tax reliefs that aim to stimulate such plans) on national saving in Spain. It tries to test the alleged positive effects of private pension plans on savings. Using a longitudinal dataset and fixed-effects methods, we find that tax-favored contributions to a pension fund are not associated with a lower consumption level, which implies that this policy does not increase national saving. The empirical results on the impact of contributions on private household wealth are less clear. [ABSTRACT FROM AUTHOR]

Gender differences in the labor market have been widely studied and discussed in terms of both research and public policy. One of the contributions of feminist economics has been to analyze and demonstrate links between gendered labor market experience and retirement incomes. This paper presents a methodology to study the dynamics of gender differences among retirees in Spain. The study provides a way to predict the effects of government policies proposed in 2011 that change the institutional framework of social security systems in an effort to address the fiscal challenges of an aging population. [ABSTRACT FROM AUTHOR]

This article analyses the redistributive impact of public health expenditure in Spain using an insurance value approach to compute individual and household's value of health services non-cash benefit. We model the intensity of use of different health care services using a count data framework on a nationally representative health care survey and then predict probabilities on the 2006 Spanish EU-SILC sample. This allows us to extend disposable income with the expected monetary value of public health services and to compare it with strictly cash income. Since non-cash income due to public health services is associated with health needs, we use needs-adjusted equivalence scales to perform distributional analysis and poverty/inequality comparisons. The results show that public health expenditure in Spain acts progressively on income distribution, and that health in-kind benefits, once considered as part of disposable income, can be extremely effective in reducing poverty and inequality. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyze the determinants of regional health-care expenditure in Spain. The coexistence of several models concerning the degree of spending power decentralization and financing systems makes Spain a singular case. It also allows us to draw conclusions relevant to other countries in decentralizing their health-care systems, and to understand cross-country differences with estimated parameters. Using data from the Spanish regions for the period 1992-2005, we show that the estimated health public expenditure income elasticity does change depending on the omission of relevant variables, econometric specifications and techniques, and institutional arrangements. Moreover, while demographic structure is a very relevant factor when explaining health-care expenditure dynamics, multicollinearity biases econometric parameter estimates. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyze the dynamic effects of the different parametric reforms oriented to reach the financial balance of public pension systems on the well-being of the retired population. Using the Spanish social security system as a case study, a duration analysis is implemented to look for a causal relationship and then estimate separately the effects of an effective retirement age delay and a replacement rate reduction as well as the combined effect of these two measures. We also estimate the effects of a delay on the reforms. We find that a change in the effective retirement age would have positive effects on the individual welfare of retired population, while a reduction of the replacement rate would diminish it. The combined effect of the two measures would finally translate into a welfare lost of the retired population. The delay on the reforms implies higher welfare loss (to the affected generations) than the analyzed reforms. [ABSTRACT FROM AUTHOR]

This paper examines the determinants of regional public health expenditure in a decentralised health system. Unlike previous studies we take into account possible policy and political interactions among authorities, as well as unobserved heterogeneity. Our emprirical contribution lies in running a spatial panel specification using a dataset of all Spanish region states on aggregated and disaggregated health expenditures (pharmaceuticals, inpatient and primary care). Results are consistent with some degree of interdependence between neighboring regions in spending decisions. Empirical evidence of long term efficiency effects of health care decentralisation, suggests that a specific spatial-institutional design might improve the health system efficiency as well as regional cohesion. Political and scale effects are consistent with theoretical predictions. [ABSTRACT FROM AUTHOR]