Regional Workshop Washington DC, USA, 29 - 30 November 2007 Venue: Inter American Development Bank...
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Regional Workshop Washington DC, USA, 29 - 30 November 2007 Venue: Inter American Development Bank IDB Enrique V. Iglesias Conference Center Room CR-2 (Annex Building) 1330 New York Avenue Health for All: Can it be financed? “Fiscal Space and the Financing of Universal Health Care Systems in the Americas: Issues and Policies”
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Transcript of Regional Workshop Washington DC, USA, 29 - 30 November 2007 Venue: Inter American Development Bank...
Regional WorkshopWashington DC, USA, 29 - 30 November 2007
Venue:Inter American Development Bank IDBEnrique V. Iglesias Conference Center
Room CR-2 (Annex Building)1330 New York Avenue
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Esperanza de Vida: Países de América Latina en 2000-05 en relación a Estados Unidos
51.8
63.4
71.2
77.7
73.8
59.7
68.9
50
55
60
65
70
75
80
1930 1950-55 1975-80 2005
Esp
era
nza
de
Vid
a (
Añ
os
)
EEUU America Latina
HAI
BOL
GUT
NICBRAPER
ELSECUPARHONDOR
COL
MEXVEN
ARGPAN
URUCHI
CUBCOR
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
América Latina: Tasa de Sobrevivencia Estandarizada (año de vida para el cual la tasa de sobreviviencia en Noruega es cero=1)
-
0.1000
0.2000
0.3000
0.4000
0.5000
0.6000
0.7000
0.8000
0.9000
1.0000
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
Edad Estandarizada
Ta
sa
de
So
bre
viv
en
cia
Bolivia Chile Costa Rica Haiti Cuba Noruega Peru Brasil
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
• Health for All? Discussion will be limited to the Financing of : – Universal Access to Health Care Services
• Public goods and services/Collective Consumption• Health Care ServicesHealth Care Services of Individual of Individual
Consumption – Public Provision: Public Consumption – Public Provision: Public (National) Health Care System ?(National) Health Care System ?
– Discussion will not be covering public policies dealing with other social determinants of populations’ health
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
• Fiscal Issues:
• Role of Government & Financing Public Policies (taxation and expenditures)
• Efficiency – Optimality (Distortions and Economic Growth)
• Redistribution – Social Justice (Incentives and Economic Growth –Robin Hood Paradox)
• What is fiscal space?
• …….. room in a government´s budget that allows it to provide resources for a desired purpose without jeopardizing the sustainability of its financial position or the stability of the economy.
• fiscal space must exist or be created if extra resources are to be made available for worthwhile government spending.
– raising taxes (What type of Taxes? – See Tanzi & Howell)
– securing outside grants,
– cutting lower priority expenditure
– borrowing resources (from citizens or foreign lenders), or borrowing from the banking system (and thereby expanding the money supply).
• But it must do this without compromising macroeconomic stability and fiscal sustainability—making sure that it has the capacity in the short term and the longer term to finance its desired expenditure programs as well as to service its debt. (Heller)
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Latin America and the Caribbean: Is there fiscal space to finance social policies – Public health care systems providing
universal access?
Organization and Financing ?
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care Systems in the
Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care Systems in the
Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care Systems in the
Americas: Issues and Policies”
Gasto Público como % del PIB; 2000-02
Sistema Nacional Sistema Nacional "Sistemas"de Total Región
de Servicios de Salud de Seguros de Salud Salud Mixtos Americas
Promedio 4.3 5.3 2.7 3.8
Promedio Ajust. */ 3.4 4.8 2.5
Max 9.1 7.0 5.8 9.1
Max */ (Max 4.4) (Max ~3.0)Min 2.5 3.7 1.6 1.6
Desviación Standard 2.3 1.1 1.1 1.9
Número de Países 12 9 15 37
*/ Excluyendo: Montserrat & Cuba Canada, EUA Bolivia
Sistemas Nacionales de Salud en Países de las Américas
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care Systems in the
Americas: Issues and Policies”
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Financing of NHCS in the Americas/Europe
GER
FRA
CAN
CHI
ARG
CORCOLMEX
NET
UK
SWE
CUB
ANT
NEA
JAP
USA
0
1
2
3
4
5
6
7
8
9
10
11
12
13
0 1 2 3 4 5 6 7 8 9 10 11 12 13
contributions
taxes
% of GDP
% of GDP
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health Care
Systems in the Americas: Issues and Policies”
Triangles of Financing of NHCS in the Americas/Europe
GER
FRA
CAN
ARG
CORCOL
USA
MEX
NET
UK
SWE
CUB
ANT
NEA
JAPCHI
average in the americas
0
1
2
3
4
5
6
7
8
9
10
11
12
13
0 1 2 3 4 5 6 7 8 9 10 11 12 13
contributions
taxes
% of GDP
% of GDP
Is there fiscal space to finance NHCS of
universal access to health care services?to expand coverage?
How?
Regional WorkshopWashington DC, USA, 29 - 30 November 2007
Venue:Inter American Development Bank IDBEnrique V. Iglesias Conference Center
Room CR-2 (Annex Building)1330 New York Avenue
Health for All: Can it be financed?“Fiscal Space and the Financing of Universal Health
Care Systems in the Americas: Issues and Policies”
