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Jose Torres
Over the last two decades, the Peruvian government has made great efforts to improve access to health care by significantly augmenting the coverage of the non-contributory public health care system Seguro Integral de Salud (SIS). This expansion has a positive impact on welfare and public health indicators, as it limits the risk of catastrophic health-related costs for previously uninsured individuals and allows for the appropriate treatment of illnesses. However, it also entails some unintended consequences for informality, tax revenues, and GDP, since a few formal agents are paying for a service that the majority of (informal) agents receive for free. In this paper, we use a general equilibrium model calibrated for Peru to simulate the expansion of SIS to quantify the unintended effects. We find that overall welfare increases, but informality rises by 2.7 percent, while tax revenues and output decrease by roughly 0.1 percent. Given the extent of the expansion in eligibility, the economic relevance of these results seems negligible. However, this occurs because the expansion of coverage was mostly funded by reducing the spending per-insured person. In fact, we find larger costs if public spending is increased to improve the quality of service given universal coverage.
International Monetary Fund. External Relations Dept.
Finances & Développement, juin 2017
International Monetary Fund. External Relations Dept.
Finanzas y Desarrollo, junio de 2017
International Monetary Fund. External Relations Dept.
This paper focuses on millennials who are increasingly looking to find their way in the sharing economy, a phenomenon made possible by the emergence of digital platforms that facilitate the matching of buyer and seller. Jobs in the sharing economy—like driving for Uber or Lyft—help some millennials make ends meet, even if such temporary gigs are a far cry from the fulltime jobs with traditional pension plans and other benefits their parents often enjoyed. This generation also enthusiastically embraces the services of the sharing economy, which provides access to everything from beds to cars to boats without the hassle of ownership. Loath to buy big-ticket items such as cars and houses, millennials have sharply different spending habits from those of preceding generations. Millennials confront obstacles to prosperity that their parents didn’t face. They are better educated than previous generations—but in today’s world, that is not enough to guarantee financial success.
International Monetary Fund. Western Hemisphere Dept.
This Selected Issues paper on United States 2012 Article IV Consultation discusses rebound of manufacturing production. The U.S. share in global manufacturing production declined through most of the past three decades, but it has stabilized since the Great Recession. It currently represents about 20 percent of global manufacturing value added. Interestingly, after a sharp increase during most of the previous decade, China’s share in global manufacturing has also stabilized since the Great Recession, at a level similar to that of the United States. The notion of a manufacturing renaissance has been fuelled partly by the rebound in production since the end of the Great Recession.
Mr. David Coady, Mr. Benedict J. Clements, and Mr. Sanjeev Gupta


Using cross-country analysis and case studies, this book provides new insights and potential policy responses for the key fiscal policy challenges that both advanced and emerging economies will be facing.

Ms. Eva Jenkner and Adam Leive
This technical note analyzes the health care spending issues in advanced economies. Both public and total health spending have increased substantially in advanced countries. Total health spending increased by more than 6 percentage points of GDP in the Organization for Economic Cooperation and Development countries between 1970 and 2007. This note examines the recent trends in health care spending in advanced countries. It discusses the main challenges for advanced countries over the medium term. Policy options for containing health care costs are also described.
Ms. Victoria Gunnarsson, Sergio Lugaresi, and Marijn Verhoeven
The paper assesses the financial situation of the health sector in the Slovak Republic. It also evaluates the efficiency of health expenditures and service delivery in comparison to the OECD and other new EU member states and suggests avenues for cost recovery and reform. The health sector of the Slovak Republic is plagued by financial problems. To turn around health system finances and achieve larger gains in health outcomes, the efficiency of health spending needs to increase and the mix and quality of real health resources need to be improved. Although Slovak's overall health spending efficiency is on par with that of the OECD, substantial inefficiencies occur in the process of transforming intermediate health inputs into health outcomes. Efficiency may be enhanced by containing the cost of drugs and reducing reliance on hospital care. Also, although cost-effectiveness may be relatively high at present, its sustainability in the future is an issue.