This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants, thanks to a reduction in the number of hospital visits involving journeys by road. Between January 2018 and June 2019, a total of 12,322 referrals were made to telemedicine services in the primary care centers, avoiding a total of 9034 face-to-face visits. In total, the distance saved was 192,682 km, with a total travel time saving of 3779 h and a total fuel reduction of 11,754 L with an associated cost of €15,664. This represents an average reduction of 3248.3 g of carbon dioxide, 4.05 g of carbon monoxide, 4.86 g of nitric oxide and 3.2 g of sulphur dioxide. This study confirms that telemedicine reduces the environmental impact of atmospheric pollutants emitted by vehicles by reducing the number of journeys made for face-to-face visits, and thus contributing to environmental sustainability.

Background: Telemedicine (interconsultation between primary and hospital care teams) has been operating in the counties of Central Catalonia Bages, Moianès and Berguedà since 2011, specializing in teledermatology, teleulcers, teleophthalmology and teleaudiometries. For the period until the end of 2019, a total of 52,198 visits were recorded. Objective: To analyze the differential costs between telemedicine and usual care in a semi-urban environment. Methodology: A cost-minimization evaluation, including direct and indirect costs from a societal perspective, distinguishing healthcare and user's costs, was carried out over a three-month period. Results: Telemedicine saved € 780,397 over the period analyzed. A differential cost favorable to telemedicine of about € 15 per visit was observed, with the patient being the largest beneficiary of this saving (by 85%) in terms of shorter waiting times and travel costs. From the healthcare system perspective, moving the time spent in a hospital care consultation to primary care is efficient in terms of the total time devoted per patient. In social terms and in this context, telemedicine is more efficient than usual care. Conclusion: Allowing users to save time in terms of consultation and travel is the main driver of interconsultation between primary and hospital care savings in a semi-urban context. The telemedicine service is also economically favorable for the healthcare system, enabling it to provide a more agile service, which also benefits healthcare professionals.

Finland is considered an example of how interventionist governmental policies work and a success under many socio-economic standards. From social indicators like inequality and crime to economic indicators like productivity and innovation the Nordic country gathers near the top. We inquire into the causes of the Finnish economic success, ascertaining which is the role of the Welfare State and the public sector in it. In fact, we examine which is the relation of causality between the good socio-economic performance and the public sector. Finland is a competitive market economy that has developed a functional Welfare State within a context of liberalisation and free choice. In this paper, we research the causes of this successful model.

The liberal world order has produced immense benefits for Europe and people across the planet. Beginning in the 18th and 19th centuries, liberalism reinforces the natural rights of man to life, liberty and property, and has transformed the world in ways that have improved the material and social circumstances of humankind. But the liberal order that has been in place in Europe since 1945, after two world wars, is showing signs of deterioration. Today, this liberal order is being challenged by a variety of forces. The essence of the European experience is the development of a civilization that considered itself to be a unity and yet was politically decentralized. Former free towns in Italy and the Low Countries became bastions of a self‑governing middle class in the Middle Ages. However, with time, states tend to overgrow taking more and more resources, which results in the increase in taxes and public spending, excessive regulation, deficits and public debt. There is a fight between the advocates of two different ideals of the European Union, the non‑liberal and the liberal vision. There is a consensus in that the market economy is the system that best produces the most, removing millions of people from poverty. But it is the unequal distribution of the wealth created that is often criticized. We examine the distribution of income, before and after taxes and transfers, concluding that market liberalization does not necessarily lead to increased social inequality. On the other hand, two of the most important threats challenging the liberal order in Europe are populist parties and protectionism. Finally, this paper suggests a way towards a future Europe, deepening the single market and economic integration, but transforming the obsolete and dysfunctional nation‑states into other forms of decentralized political units.

Expansionary monetary and fiscal policies followed the 2008