The healthcare sector is looking for its therapy

BarcelonaIt is the third largest sector in terms of economic weight in Catalonia, accounting for nearly 10% of all the wealth generated annually and contributing one in 10 workers to the economy. These figures reflect the importance of the healthcare sector, surpassed only by tourism and commerce. It is a "fantastic" model, but one that is becoming "obsolete," according to Núria Mas, professor of economics at the Jaime Grego Chair of Global Healthcare Management at Iese. Measures are therefore needed to strengthen it in a context dominated by population aging and its effects. Ending underfunding is one of the essential objectives, considering that more than 72% of spending corresponds to the public sector. One of the keys is the alliance with the private sector.

Mas asserted that Catalonia "has the elements that make up a good ecosystem, from universities to business schools and startups, but the pieces still need to be put together." The warnings came during his speech at the event held on October 9 in Món Sant Benet, marking the 50th anniversary of the Union. This association of health and social entities brought together more than 250 leading figures from the socioeconomic world and executives from the health and social sectors, including the PSC (Socialist Workers' Party) with its presidents Pasqual Maragall and José Montilla, and Boi Ruiz in the Artur Mas administration.

In the words of the President of the Union, Joan Maria Adserà, representatives of this sector constitute "a driving force of economic progress, social cohesion, and territorial balance" worth taking into account. The fact is that the power of this activity is gaining momentum with establishments such as the Fraunhofer Center for Applied Theragnosis (Fraunhofer-CAT), of the German Fraunhofer Institute, one of the world's leading applied research centers, in collaboration with the Institute for Bioengineering of Catalonia (IBEC), which will be located in Barcelona. Theragnosis is an innovative technique in nuclear medicine that combines therapy with diagnosis and will represent a qualitative leap for the sector's ecosystem. As the Minister of Science, Diana Morant, stated upon signing the agreement with the German institute, this establishment, which has the support of the central, regional, and local governments, "consolidates Barcelona as the scientific capital of the country."

The employers' association Foment del Treball (Foment del Treball) expressed a similar opinion regarding the sector, whose president, Josep Sánchez Llibre, stated that the healthcare sector "is a strategic pillar of the Catalan economy" as well as "an economic and social engine." And the president of the Barcelona Chamber of Commerce, Josep Santacreu, who is highly knowledgeable about the sector because he was CEO of the health insurance company DKV for many years, criticized the fact that the sector has "been viewed too publicly." In his opinion, more leeway should be given to the private sector and, in particular, a commitment should be made to prioritizing Catalan companies, which are sometimes at a disadvantage compared to those from other countries. In fact, the importance of strengthening the network of startups specialized as suppliers to the public sector.

Ricard Fabregat, director of Biocat, recalled the importance of the activity, which employs 280,000 people in Catalonia, with more than 1,500 companies, of which more than 500 are startupsLast year, this ecosystem raised €347 million, and during the first half of the current year, this figure has already been surpassed.

For her part, the Minister of Economy acknowledged the challenges facing the sector, such as the aging population and the resulting increase in chronic diseases. These are factors that force the system to adapt to new realities. And one of the first steps should be to make the public budget, the main driver of activity, increasingly "more realistic." In fact, some €16 billion of a total of €37 billion in public accounts are being executed, she explained.

But on paper, the figure is lower. The initial budget for 2025 (extended from 2023) was €11.25 billion, and on June 30th it stood at €13.27 billion. And all this increases the spending carried over from one year to the next, as reflected in the General Account of the Generalitat: in 2024, of the more than €4.7 billion in displaced spending, €3.047 billion were outstanding invoices from the Catalan Health Service (SCS) and the Catalan Health Institute (ICS). This shows that the system's underfunding is one of the problems to be solved.

Catalonia is the third autonomous community in healthcare expenditure per capita, with €3,029, behind the Basque Country (€3,081) and Asturias (€3,052). However, it is not one of the regions that allocates the most money per inhabitant to public spending (2,126 euros per inhabitant) and has a significant proportion of private spending (903), which represents around 30% of total spending, above the Spanish average of 26%.

Núria Mas, in addition to warning about the need to adapt the healthcare system to the needs of today's patients, stated that to maintain excellence, the system must be sustainable. She also advocated "making the most of" data, that is, with all the necessary privacy precautions, allowing it to be used for research. All of this is to strengthen the model, which should be a priority, since healthcare "is what Europe does best" compared to other activities in which it has lagged behind. This has happened, for example, with technology, or as has happened to a power like Germany, which "must reinvent itself" after its automotive industry was overtaken by the Chinese electric vehicle industry.

Mas warned that healthcare, an element of competitiveness, must face intense financial pressures, such as the trend toward increasing resources for defense, an aging population, and public debt, in addition to new patient needs, inefficiencies, and new business models.

One of the most recent studies on the healthcare sector is that of the Economic and Social Work Council of Catalonia (CTESC). The analysis includes activities that directly or indirectly enable the provision of healthcare services: pharmacy, wholesale of pharmaceutical products, social services, health research and development (R&D), retail of pharmaceutical products, medical instruments, health-related insurance, central services of the public health administration, and medical equipment. From all this, it is concluded that the healthcare sector ranks third in the Catalan economy in terms of added value, and its weight as a percentage of GDP has been growing. It also ranks third in terms of employment.

The BioRegion is emerging as an economically important sector, with the capacity for growth, attracting talent and investment, and demonstrating specialization in areas such as oncology and neurology. The CTESC warns that political action "should preserve this ecosystem as a new model of productive economy to address future challenges that the healthcare system requires." The data show that public spending accounts for the majority of total healthcare expenditure, but private healthcare spending has gained ground.

Based on the report's findings, the CTESC notes that the healthcare sector is strategic from both an economic and social perspective. During the COVID-19 pandemic, for example, the centrality of healthcare to economic activity and social life was highlighted.

On the one hand, the healthcare sector is strategic as a generator of economic activity, research, knowledge, innovation, jobs, and knock-on effects. It stands out for the volume and quality of its research, employment, and investment it represents. For example, the BioRegion offers unique and cutting-edge capabilities in genomics, structural biology, medicinal chemistry, nanomedicine, bioinformatics, big data and conducting clinical trials, especially in the field of oncology, where Catalonia is a world leader. Furthermore, the public and universal healthcare system guarantees social cohesion, "since it allows for the reduction of socioeconomic inequalities through direct care and the creation of healthier environments," according to this organization.