The emergence of financial capital in the health insurance business in Europethe case of Spain in the last fifty years

  1. Margarita Vilar-Rodríguez 1
  2. Jerònia Pons-Pons 2
  1. 1 Universidade da Coruña
    info

    Universidade da Coruña

    La Coruña, España

    ROR https://ror.org/01qckj285

  2. 2 Universidad de Sevilla
    info

    Universidad de Sevilla

    Sevilla, España

    ROR https://ror.org/03yxnpp24

Journal:
Revista de Historia Económica = Journal of Iberian and Latin American Economic History

ISSN: 0212-6109

Year of publication: 2024

Year: 42

Issue: 2

Pages: 217-242

Type: Article

DOI: 10.1017/S0212610924000016 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista de Historia Económica = Journal of Iberian and Latin American Economic History

Abstract

Sickness insurance companies were developed in Spain by doctors and healthcare professionals, remaining outside the interests of general insurance companies. Their management was hardly professional, with limited actuarial techniques and they only accounted for a small percentage of total insurance business premiums. From the 1970s onwards, various factors changed this situation, driving processes of concentration, with numerous takeovers and mergers, first reducing the number of local and regional companies to the benefit of companies of national scope. Subsequently, the growth in demand for this type of coverage sparked the interest of national general insurance companies and multinationals, leading to a restructuring of the sector which has progressively acquired greater weight within the insurance business and become increasingly internationalised. This last stage immersed the health sector in Spain in the great processes of globalisation of the sector, characterised by a financialisation of capital promoted by the bank investment funds. These processes are little known and are the focus of analysis of this paper, with the aim of enabling comparison at international level.

Bibliographic References

  • Ashford, D. E. (1989): La Aparición de los Estados de Bienestar. Madrid: Ministerio de Trabajo y Seguridad Social.
  • Baldwin, P. (1992): The Politics of Social Solidarity: Class Bases of the European Welfare State, 1875-1975. Cambridge: Cambridge University Press.
  • Borscheid, P. (2013): «La concentration de l’industrie de l’assurance en Allemagne». Entreprises et Histoire 72, pp. 21-35.
  • Borscheid, P., and Haueter, N. V. (eds) (2012): World Insurance. The Evolution of a Global Risk Network. Oxford: Oxford University Press.
  • Carreño, F. (1996): «La intercooperación de la actividad sanitaria. El largo camino hacia el cooperativismo sanitaria integral». REVESCO Revista de Estudios Cooperativos 62 nov., pp. 157-162.
  • Chapin, C. F. (2015): Ensuring America’s Health. New York: Cambridge University Press.
  • Chapin, C. F. (2020a): «What Historians of Medicine Can Learn from Historians of Capitalism». Bulletin of the History of Medicine 94 (3), pp. 319-367.
  • Chapin, C. F. (2020b): «Reply: What Historians of Medicine Can Learn from Historians of Capitalism». Bulletin of the History of Medicine 94 (3), pp. 388-393.
  • Cherry, S. (1997): «Before the National Health Service: Financing the Voluntary Hospitals, 1900-1939». The Economic History Review 50 (2), pp. 305-326.
  • Chevandier, C. (2009): L’hôpital dans la France du XXe siècle. Paris: Perrin.
  • Companje, K. P., Hendriks, R. H. M., Veraghtert, K. F. E., and Widdershoven, B. E. M. (2009): Two Centuries of Solidarity: German, Belgian, and Dutch Social Health Insurance, 1770-2008. Amsterdam: Aksant Academic Publishers.
  • Cordilha, A. C. (2023): «Public health systems in the age of financialization: lessons from the French case». Review of Social Economy 81 (2), pp. 246-273, doi: 10.1080/00346764.2020.1870710
  • Davis, G. F., and Kim, S. (2015): «Financialization of the Economy». Annual Review of Sociology 41 (1), pp. 203-221.
  • de Ferranti, D. (1985): «Paying for Health Services in Developing Countries: An Overview». World Bank Staff Working Papers 721. Link: https://documents1.worldbank.org/curated/en/485471468739208102/pdf/ multi0page.pdf
  • Domin, J-P. (2008): Une histoire économique de l’hôpital (XIXe-XXe siècles). Une analyse rétrospective du développement hospitalier, Tome I (1803-1945). Paris: Comité d’histoire de la Sécurité Sociale.
  • Donzé, P-Y., and Fernández, P. (2019): «Health Industries in the Twentieth Century». Business History 61 (3), pp. 385-403.
  • Doyle, Y., and Bull, A. (2000): «Role of Private Sector in United Kingdom Healthcare System». BMJ British Medical Journal sep. 2; 321(7260), pp. 563-565.
  • Dreyfus, M. (2009): Les Assurances Socials en Europe. Rennes: Presses Universitaires de Rennes.
  • Duckett, J. (2011): The Chinese State’s Retreat from Health: Policy and the Politics of Retrenchment. London: Routledge.
  • Dutton, P. V. (2002): Origins of French Welfare State. The Struggle for Social Reform in France 1914-1947. Cambridge: Cambridge University Press.
  • Fraser, D. (2003): The Evolution of the British Welfare State. Nueva York: Palgrave Macmillan.
  • Ginzberg, E. (1986): «The Destabilization of Health Care». N. Engl. J. Med. 315, pp. 757-761.
  • Gorsky, M., Mohan, J., and Powell, M. (2002): «The Financial Health of Voluntary Hospitals in Interwar Britain». Economic History Review 55, pp. 533-557.
  • Gorsky, M., and Sheard, S. (eds) (2006): Financing Medicine: The British Experience Since 1750. London: Routledge Studies in the Social History of Medicine.
  • Gorsky, M., Vilar-Rodríguez, M., and Pons-Pons, J. (eds) (2020): The Political Economy of the Hospital in History. Huddersfield: Huddersfield U.P.
  • Granshaw, L., and Porter, R. (1989): The Hospital in History. London and New York: Routledge.
  • Grell, O. P., Cunningham A., and Jütte, R. (eds) (2002): Healthcare and Poor Relief in 18th and 19th Century Northern Europe. Aldershot: Ashgate.
  • Harris, B. (2004): The Origins of the British Welfare State. Social Welfare in England and Wales, 1800-1945. Nueva York: Palgrave Macmillan.
  • Herranz, A. (2010): «La difusión internacional de los seguros sociales antes de 1945», in J. Pons, and J. Silvestre (eds), Los orígenes del estado de bienestar en España, 1900-1945. Zaragoza: Prensas Universitarias de Zaragoza, pp. 51-83.
  • Hilger, S. (1998): «Welfare Policy in German Big Business after the First World War: Vereinigte Stahlwerke AG, 1926-33». Business History 40 (1), pp. 50-76.
  • Hoffman, B. (2020): «Comment: What Historians of Medicine Can Learn from Historians of Capitalism», Bulletin of the History of Medicine 94 (3), pp. 368-373.
  • Hüntelmann, A. C. (2020): «Principles and Problems of Hospital Funding in Germany in the Twentieth Century» in M. Gorsky, M. Vilar-Rodríguez, and J. Pons-Pons (eds), The Political Economy of the Hospital in History. Huddersfield: Huddersfield U.P., pp. 95-136.
  • Hunter, B. M., and Murray, S. F. (2019): «Deconstructing the Financialization of Healthcare». Development and Change 50 (5), pp. 1263-1287.
  • Lapidus, J. (2019): The Quest for a Divided Welfare State: Sweden in the Era of Privatization. Cham: Palgrave Macmillan.
  • Lapidus, J. (2022): «Privatising, liberalising and dividing a welfare state without affecting universality? Debunking the myths surrounding the rapid rise of private health insurance in Sweden». Health Economics, Policy, and Law apr. 6, pp. 1-13.
  • Lavinas, L. (2018): «The Collateralization of Social Policy under Financialized Capitalism». Development and Change, International Institute of Social Studies 49 (2), pp. 502-517.
  • Montijano, F. (2010): «Las relaciones banca-seguros: consideraciones históricas y actuales», in J. Pons, and M. A. Pons (eds), Investigaciones históricas sobre el Seguro español. Madrid: Fundación Mapfre, pp. 259-273.
  • Mossialos, E., Dixon, A., Figueras, J., and Kutzin, J. (eds) (2002): Funding Health Care: Options for Europe. Buckingham: Open University Press.
  • Murray, J. E. (2007): Origins of American Health Insurance. A History of Industrial Sickness Funds. New Haven and London: Yale University Press.
  • Olivas, A. (2008): «El ramo de salud no creo que le afecte la crisis» Asseguranza 128, pp. 14-24.
  • Ordaz Sanz, J. A. (2003): «Análisis del seguro privado de enfermedad en España». The University of Seville, Doctoral thesis. Available online at: https://idus.us.es/bitstream/handle/11441/15684/Original_M_TD-0494.pdf? sequence=1&isAllowed=y
  • Packard, R. M. (2016): A History of Global Health: Interventions into the Lives of Other People. Baltimore: Johns Hopkins University Press.
  • Pearson, R. (2013): «Mergers and concentration in the UK insurance industry». Entreprises et Histoire 72, pp. 7-20.
  • Polanyi, K. ([1944] 1997): La Gran Transformación. Madrid: La Piqueta.
  • Pons-Pons, J. (2008): «Multinational Enterprises and Institutional Regulation in the Life-Insurance Market in Spain, 1880-1935». Business History Review 82 (1), pp. 87-114.
  • Pons-Pons, J. (2013): «The Insurance Market in Spain: From Fragmentation to Concentration (1880-2010)». Entreprises et Histoire 72, pp. 36-54.
  • Pons-Pons, J. (2000): «Marcial Gómez Gil (1906-1990)», in E. Torres (coord.) and G. Tortella (pr.), Los 100 empresarios españoles del siglo XX. Madrid: LID Editorial Empresarial, pp. 428-431.
  • Pons-Pons, J., and Vilar-Rodríguez, M. (2014): El Seguro de Salud Privado y Público en España: Su análisis en perspectiva histórica (1880-2010). Zaragoza: Prensas Universitarias de Zaragoza.
  • Pons-Pons, J., and Vilar-Rodríguez, M. (2019): «The Genesis, Growth and Organisational Changes of Private Health Insurance Companies in Spain (1915-2015)». Business History 61 (3), pp. 558-579.
  • Risse, G. B. (1999): Mending Bodies, Saving Souls: A History of Hospitals. New York: Oxford University Press.
  • Ritter, G. (1991): El Estado Social, su origen y desarrollo en una comparación internacional. Madrid: Centro de Publicaciones Ministerio de Trabajo y Seguridad Social.
  • Sawyer, M. C. (2013): «What is Financialization?» International Journal of Political Economy 42 (4), pp. 5-18.
  • Serra, V. M., Gómez, M. A., and Landete, M. (2001): «Resultados de las fusiones empresariales: una aproximación empírica en el sector asegurador». Revista Española de Financiación y Contabilidad 110, pp. 1001-1036.
  • Starr, P. (2011): Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform. New Haven: Yale University Press.
  • Straus, A. (2013): «La concentration des entreprises d’assurances en France depuis la Seconde Guerre Mondiale : réalités et limites». Entreprises et Histoire 72 (3), pp. 55–79.
  • Thane, P. (1982): The Foundations of the Welfare State. Londres: Longman.
  • Thomasson, M. A. (2000): «From Sickness to Health: The Twentieth-Century Development of the Demand for Health Insurance». The Journal of Economic History 60 (2), pp. 504-508.
  • Thomasson, M. A. (2002): «From Sickness to Health: The Twentieth-Century Development of U.S. Health Insurance». Explorations in Economic History 39 (3), pp. 233-253.
  • Tomes, N. (2020): «Comment: What Historians of Medicine Can Learn from Historians of Capitalism». Bulletin of the History of Medicine 94 (3), pp. 374-383.
  • Tortella, G., Caruana, L., García Ruíz, J. L., Manzano, A., and Pons, J. (2014): Historia de Seguro en España. Madrid: Fundación Mapfre.
  • Uri, A. (1989): «Seguros de salud en España». Revista Trébol. Publicación de Mapfre Re 11 abril, pp. 2-4.
  • Verhoef, G. (2006): «From Friendly Society to Compulsory Medical Aid Association: The History of Medical Aid Provision in South Africa’s Public Sector, 1905-1970». Social Science History 30 (4), pp. 601-627.
  • Vilar-Rodríguez, M., and Pons-Pons, J. (eds) (2018): Un siglo de hospitales entre lo público y lo privado (1886-1986) [Financiación, gestión y construcción del sistema hospitalario español]. Madrid: Marcial Pons.
  • Vilar-Rodríguez, M., and Pons-Pons, J. (2019): «Competition and Collaboration Between Public and Private Sectors: The Historical Construction of the Spanish Hospital System 1942-86». Economic History Review 72 (4), pp. 1384–1408.
  • Vilar-Rodríguez, M., and Pons-Pons, J. (2020): «La Ley de Bases de la Seguridad de 1963: ¿una oportunidad perdida?», in D. A. González, and M. Ortiz (eds), El Estado de Bienestar entre el franquismo y la transición. Madrid: Sílex, pp. 125-156.
  • Vonk, R. (2012): «In it for Money? Insurers, Sickness Funds and the Dominance of Not for Profit Health Insurance in the Netherlands», in B. Harris (ed.), In Welfare and Old Age in Europe and North America: The Development of Social Insurance. Londres: Pickering and Chatto, pp. 167-188.
  • Waitzkin, H. (ed.) (2020): «Moving Beyond Capitalism for Our Health». International Journal of Health Services Oct. 50 (4), pp. 458-462.
  • Harris, B., and Bridgen, P. (eds) (2007): Charity and Mutual Aid in Europe and North America Since 1800. London & New York: Routledge Studies in Modern History.
  • Tirado Suárez, F. J. (1984): Ley ordenadora del seguro privado. Exposición y crítica. Sevilla: Universidad de Sevilla.
Data source: Dialnet