The challenge of budgeting for healthcare programmes:

The OECD has created a Joint Network on Fiscal Sustainability of Health Systems. This article, developed as input to that project, seeks to summarise both why budgeting for healthcare is particularly challenging and why the challenge is often misunderstood. I argue that sustainability is a political...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
1. Verfasser: White, Joseph (VerfasserIn)
Format: Elektronisch Buchkapitel
Sprache:English
Veröffentlicht: Paris OECD Publishing 2014
Schlagworte:
Online-Zugang:DE-384
DE-473
DE-824
DE-29
DE-739
DE-355
DE-20
DE-1028
DE-1049
DE-521
DE-861
DE-898
DE-92
DE-91
DE-573
DE-19
URL des Erstveröffentlichers
Zusammenfassung:The OECD has created a Joint Network on Fiscal Sustainability of Health Systems. This article, developed as input to that project, seeks to summarise both why budgeting for healthcare is particularly challenging and why the challenge is often misunderstood. I argue that sustainability is a political, not fiscal, issue; that common explanations of increased spending, such as "ageing" and "technology", are either inaccurate or unhelpful; and that the nature of public support for healthcare means that standard budgetary worldviews may not be appropriate in a representative system. For example, both a focus on "fiscal space" and distrust of dedicated revenues may be contrary to budgetary values of both representation and balance. I offer explanations of why demand for healthcare spending both is peculiarly intense and tends to expand because notions of "necessary" care expand. Budget-making is made more difficult by a uniquely confusing proliferation of ideas about how to control spending, many of which are supported more by disciplinary biases than by hard evidence. I conclude by considering the impact of two structural features: whether services are delivered by a bureau or as an entitlement, and whether it is funded by dedicated revenues. The challenges can be met, but hardheaded and sceptical budget analysis is especially important. JEL classification: H51, H6, E62, H2, I1, J11, O33, P16, Z18 Keywords: Budgeting, healthcare spending, ageing society, Baumol's disease, dedicated revenues, efficiency, entitlements, redistribution, technology, unsustainability
Beschreibung:1 Online-Ressource (35 Seiten) 21 x 28cm
DOI:10.1787/budget-14-5jxst2mfm923

Es ist kein Print-Exemplar vorhanden.

Fernleihe Bestellen Achtung: Nicht im THWS-Bestand! Volltext öffnen