The Catalan healthcare system is in crisis and faces a number of significant general challenges: climate change, globalization, new technologies, and artificial intelligence, in addition to more specific ones such as budget shortfalls, shortages of doctors and nurses, and demographic changes. Catalonia is one of the regions with the highest life expectancy and, at the same time, has a mortality rate exceeding its birth rate; that is, negative population growth. The combination of high life expectancy, low mortality, and low birth rate leads to a highly aged population. In 30 years, the percentage of the population aged 65 or over will exceed 30%, and of these, those aged 80 or over will approach 40%. It's not new, but it's a persistent trend with significant consequences for the healthcare system: greater frailty, an increase in chronic illnesses and multiple conditions, higher levels of dependency, and greater demand for care and social support. At the same time, Catalonia's population is growing. We are no longer the 6 million of the 1980s: we have surpassed 8 million. And this is thanks to immigration. It is estimated that by 2039 we will be more than 9 million. Thus, we have two patterns that entail two seemingly contradictory realities: simultaneous aging and population growth, both impacting healthcare demand and spending. Ultimately, our healthcare system is still based on the model of the 1980s, but the entire environment has changed. We start from a position of chronic underfunding, and the political, social, and economic outlook suggests that future priorities will not include strengthening the welfare state. On the other hand, there is a shortage of healthcare professionals, especially doctors and nurses. Increased demand and a lack of staff mean overcrowding. And, by the way, artificial intelligence can be very useful, but it doesn't work miracles. It's a complement, not a substitute.

The law establishing the Integrated Social and Health Care Agency is expected to be approved this fall. If it is passed, it will be a momentous milestone—without exaggeration—in the way we understand the coverage of citizens' material and health needs in this country, with broad consensus on their interrelationship.