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Business and Economics > Public Finance

You are looking at 1 - 10 of 27 items for :

  • Type: Journal Issue x
  • Health: Government Policy; Regulation; Public Health x
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Cover IMF Working Papers
Designing Expenditure Policy Conditionality in IMF-Supported Programs
Emine Hanedar
and
Zsuzsa Munkacsi
This gap-filling paper provides granular advice on how to design quantitative and structural conditionality of IMF-supported programs in six expenditure policy areas: social assistance, energy subsidies, pension spending, health spending, education spending, and wage bill management. Such granular advice is based on a stocktaking exercise: an analysis of 105 programs approved between 2002 and July 2021 containing a ca. 1400 conditions. Conditions are key to identify outcomes or actions seen as critical for program success or monitoring, and so are essential for financial support countries can receive from the Fund.
Keywords:
IMF-supported programs; conditionality; expenditure policy; social assistance; energy subsidies; pension spending; health spending; education spending; wage bill management; policy conditionality; policy area; IMF working papers; reform plan; E. public health spending; Health care spending; Caribbean; North Africa; Middle East; East Africa; Europe
Cover Technical Notes and Manuals
IMF Engagement on Health Spending Issues in Surveillance and Program Work
Mauricio Soto
,
Geremia Palomba
,
Carolina Bloch
,
Nick Carroll
,
Tohid Atashbar
,
Deeksha Kale
,
Baoping Shang
,
Kiichi Tokuoka
,
Ruud de Mooij
, and
Guillaume Chabert
IMF country teams have become increasingly engaged on health spending issues in surveillance and program work, and more so since the COVID-19 pandemic. The primary objectives of health spending are to improve health outcomes and provide protection to households against high financial costs of health care. The Fund’s engagement on health spending issues is guided by an assessment of its macro-criticality, with the scope and purpose of engagement varying across countries and depending on whether it occurs in surveillance or program contexts. This technical note discusses how to assess the macro-criticality of health spending and reviews appropriate policy responses. The design and implementation of macro-critical health reforms often require specific sectoral knowledge and experience. Thus, this note emphasizes the importance of collaborating with development partners on health policy issues.
Keywords:
Fiscal Policy; Health spending; Spending adequacy; Spending Efficiency; Fiscal Sustainability; policy reform; data IMF Library; IMF engagement; policy option; health system; Health care spending; Health care; Health care reform; Global
Cover IMF Working Papers
Rising Child Poverty in Europe: Mitigating the Scarring from the COVID-19 Pandemic
Mr. Jean-Jacques Hallaert
,
Iglika Vassileva
, and
Tingyun Chen
Child poverty increased dramatically during the COVID-19 pandemic. In 2020 alone, the number of children suffering from poverty in the EU increased by 19 percent, or close to 1 million. Left unaddressed, this would not only affect individuals’ life prospects and well-being but also have long-term economic implications. This paper argues that, to limit this potential scarring effect of the pandemic, policies should be deployed to reduce rapidly the number of children affected by poverty and mitigate the long-term impact of poverty. Reducing the number of children affected by poverty can be achieved by (i) labor policies and reforms that increase parental work and the labor income of poor parents and (ii) fiscal spending on family and children that can have a powerful and immediate impact. These policies need to be complemented by public investment in education and childcare, health, and housing to mitigate the long-term impact of child poverty.
Keywords:
child poverty; EU assistance; scarring effect; C. measuring poverty; summary plot; labor income; COVID-19; Income; Poverty reduction; Social protection spending; Europe
Cover IMF Working Papers
Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance
Ryota Nakatani
,
Qianqian Zhang
, and
Isaura Garcia Valdes
Does fiscal decentralization improve health and educational outcomes? Does this improvement depend on the quality of governance? How do fiscal decentralization and governance interact? We answer these questions through an instrumental variable Tobit analysis of cross-country panel data. We find negative effects of fiscal decentralization on health outcomes, which however are more than offset by better governance. Education expenditure decentralization to subnational governments enhances educational outcomes. We conclude that countries can only reap the benefits from decentralization when the quality of their governance arrangements exceeds a certain threshold. We also find that sequencing and staging of decentralization matter. Countries should improve government effectiveness and control of corruption first to maximize benefits of fiscal decentralization.
Keywords:
Fiscal Decentralization; Governance; Corruption; Health; Education; education expenditure decentralization; government effectiveness; decentralization matter; Subnational government; health outcome; governance Indicator; Fiscal federalism; Health care spending; Global
Cover IMF Working Papers
Health Care Reform in Greece: Progress and Reform Priorities
Niki Kalavrezou
and
Hui Jin
We review Greek public sector healthcare policies and health-related outcomes since 2010.We find that excess spending was successfully curtailed, elements of the institutional framework were modernized, and health outcomes have been relatively favorable. However, especially prior to Covid-19, public healthcare spending had been compressed to potentially unsustainable levels, with widening inequalities and large unmet needs, especially among the poor. Higher public spending and advancing structural healthcare reforms are needed to improve the efficiency and equity of the Greek healthcare system, including strengthening primary healthcare, reducing out-of-pocket payments, and eliminating remaining insurance gaps.
Keywords:
healthcare; health policy; structural reforms; health insurance; healthcare reform; reform priority; health outcome; healthcare policy; Health care spending; Total expenditures; Europe
Cover IMF Working Papers
Exiting from Lockdowns: Early Evidence from Reopenings in Europe
Mr. Jeffrey R. Franks
,
Bertrand Gruss
,
Mr. Carlos Mulas-Granados
,
Manasa Patnam
, and
Mr. Sebastian Weber
European authorities introduced stringent lockdown measures in early 2020 to reduce the transmission of COVID-19. As the first wave of infection curves flattened and the outbreak appeared controlled, most countries started to reopen their economies albeit using diverse strategies. This paper introduces a novel daily database of sectoral reopening measures in Europe during the first-wave and documents that country plans differed significantly in terms of timing, pace, and sequencing of sectoral reopening measures. We then show that reopenings led to a recovery in mobility—a proxy for economic activity—but at the cost of somewhat higher infections. However, the experience with reopening reveals some original dimensions of this trade-off. First, the increase in COVID-19 infections after reopening appears less severe in fatality rates. Second, a given reopening step is associated with a worse reinfection outcome in countries that started reopening earlier on the infection curve or that opened all sectors at a fast pace in a relatively short time. Finally, while opening measures tend to have an amplification effect on subsequent cases when a large fraction of the economy is already open, this effect appears heterogenous across sectors.
Keywords:
Pandemics; Lockdowns; Europe; WP; reopening policy; infection curve; infection amplification risk; infection dynamics; infection-death curve; outcome variable; infection evolution; infection variable; infection situation; effect of reopening; COVID-19; Public expenditure review
Cover IMF Working Papers
Benchmarking Social Spending Using Efficiency Frontiers
Mr. Javier Kapsoli
and
Iulia Ruxandra Teodoru
Developing and low-income economies face the challenge of increasing public spending to address sizeable infrastructure and social gaps while simultaneously restoring the fiscal discipline weakened to countervail the effect of the global recession. Increasing the efficiency of social spending could be the key policy to address the dilemma as it allows the optimization of the existing resources by reducing spending inefficiencies. This paper quantifies the efficiency gap in the health and education sectors for a large sample of developing and emerging countries and proposes measures to reduce these gaps for the specific cases of El Salvador, Guatemala, and Honduras.
Keywords:
WP; public spending; wage; Honduras; spending; Guatemala; wage bill; Health; education; efficiency; developing countries; low-income countries; technical efficiency; efficiency saving; public spending in education; social spending trend; efficiency score; Education spending; Health care spending; Central America
Cover Technical Notes and Manuals
Expenditure Assessment Tool
Miss Candice Y Liu
and
Ms. Mercedes Garcia-Escribano
This manual presents the Expenditure Assessment Tool (EAT), which helps assess expenditures for any specific country. EAT uses the commonly available software program Excel and has been designed by Expenditure Policy Division at Fiscal Affairs Department at IMF. The information EAT provides can be very useful in the evaluation of government spending and in the identification of areas where there may be room to increase spending efficiency or rationalize spending. The evaluation is done through benchmarking of spending—levels, composition and outcomes—against regional and income comparators. The focus is on both the economic and functional classification of expenditures. The application of the tool to spending in Argentina is presented as an illustration.
Keywords:
TNM; spending; country; GDP; spending reform; Public expenditure review; spending efficiency; benchmarking; IMF FAD Expenditure Assessment Tool; wage bill; spending increase; IMF FAD government Compensation; health expenditure metrics; reflecting spending growth; public health expenditure; investment spending; tax subsidy; wage differential; income group; Health care spending; Education spending; Total expenditures; South America
Cover IMF Working Papers
From Expenditure Consolidation to Expenditure Efficiency: Addressing Public Expenditure Pressures in Lithuania
Mr. David Coady
and
Ms. Nan Geng
This paper reviews public expenditure in Lithuania to identify areas where deeper structural reforms may be warranted to improve spending efficiency and contain future spending pressures. The analysis benchmarks spending in Lithuania against other European countries focusing on spending levels, spending composition, and spending outcomes, and for both economic and functional spending classifications. While recent expenditure consolidation efforts have kept public spending among the lowest in Europe, a transition from broad-based measures to more structural measures will be required: to ensure that low spending levels remain sustainable, to address poor social outcomes such as high inequality and poor health and education outcomes, and to efficiently and equitably contain spending pressures arising from an ageing population.
Keywords:
WP; pay; spending; base wage; EU average; wage bill; public expenditure review; spending efficiency; equity; benchmarking; Lithuania; European countries; consolidation measure; employment level; bill reduction; disability benefit; Health care; Wages; Europe
Cover IMF Working Papers
Health Spending in Japan: Macro-Fiscal Implications and Reform Options
Mr. Masahiro Nozaki
,
Kenichiro Kashiwase
, and
Ikuo Saito
Health spending has risen rapidly in Japan. We find two-thirds of the spending increase over 1990–2011 resulted from ageing, and the rest from excess cost growth. The spending level will rise further: ageing alone will raise it by 3½ percentage points of GDP over 2010–30, and excess cost growth at the rate observed over 1990–2011 will lead to an additional increase of 2–3 percentage points of GDP. This will require a sizable increase in government transfers. Japan can introduce micro- and macro-reforms to contain health spending, and financing options should be designed to enhance equity.
Keywords:
WP; cost growth; cost; profile shift; Japan; health spending; long-term care; fiscal policy; spending ratio; health status; health outcome; spending data; health system; spending increase; copayment rate; health risk; budget target; LTC spending; health spending growth; Health care spending; Aging; Health care; Global