This presentation by Tamas EVETOVITS was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
Adapting revenue policies to health needs and expenditure projections - Tamas...OECD Governance
This presentation was made by Tamas Evetovits and Sarah Thomson, WHO, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Budgeting for healthcare - Camila Vammalle, OECDOECD Governance
This presentation was made by Camila Vammalle, OECD, at the 11th Annual Meeting of Central, Eastern and South-Eastern Senior Budget Officials (CESEE SBO) held in Warsaw, Poland, on 21-22 May 2015.
This fourth edition of Health at a Glance: Europe presents key indicators of health and health systems in the 28 EU countries, 5 candidate countries to the EU and 3 EFTA countries. This 2016 edition contains two main new features: two thematic chapters analyse the links between population health and labour market outcomes, and the important challenge of strengthening primary care systems in European countries; and a new chapter on the resilience, efficiency and sustainability of health systems in Europe, in order to align the content of this publication more closely with the 2014 European Commission Communication on effective, accessible and resilient health systems. This publication is the result of a renewed collaboration between the OECD and the European Commission under the broader "State of Health in the EU" initiative, designed to support EU member states in their evidence-based policy making.
Long-term care: Integrating health and social care - Albert Veraart, NetherlandsOECD Governance
This presentation was made by Albert Veraart, Netherlands, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Adapting revenue policies to health needs and expenditure projections - Tamas...OECD Governance
This presentation was made by Tamas Evetovits and Sarah Thomson, WHO, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Budgeting for healthcare - Camila Vammalle, OECDOECD Governance
This presentation was made by Camila Vammalle, OECD, at the 11th Annual Meeting of Central, Eastern and South-Eastern Senior Budget Officials (CESEE SBO) held in Warsaw, Poland, on 21-22 May 2015.
This fourth edition of Health at a Glance: Europe presents key indicators of health and health systems in the 28 EU countries, 5 candidate countries to the EU and 3 EFTA countries. This 2016 edition contains two main new features: two thematic chapters analyse the links between population health and labour market outcomes, and the important challenge of strengthening primary care systems in European countries; and a new chapter on the resilience, efficiency and sustainability of health systems in Europe, in order to align the content of this publication more closely with the 2014 European Commission Communication on effective, accessible and resilient health systems. This publication is the result of a renewed collaboration between the OECD and the European Commission under the broader "State of Health in the EU" initiative, designed to support EU member states in their evidence-based policy making.
Long-term care: Integrating health and social care - Albert Veraart, NetherlandsOECD Governance
This presentation was made by Albert Veraart, Netherlands, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Ageing: Fiscal implications and policy responses -- John Beard, World Health ...OECD Governance
This presentation was made by John Beard, WHO, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
The fiscal sustainability of long-term care and its impact on health systems ...OECD Governance
This presentation was made by Tim Muir, OECD, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Ageing: Fiscal implications and policy responses -- Mirko Lichetta, United Ki...OECD Governance
This presentation was made by Mirko Lichetta, United Kingdom, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Structure and governance of financing - Tamas Evetovits, WHOOECD Governance
This presentation was made by Tamas Evetovits, WHO, at the 2nd Health Systems joint Network Meeting for Central, Eastern and Southeastern European Countries held in Tallinn, Estonia, on 1-2 December 2016
This presentation by Sarah THOMSON was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
This presentation was made by Tamas EVETOVITS, WHO Barcelona Office, at the 5th Meeting of the joint OECD DELSA/GOV Network on Fiscal Sustainability of Health Systems held on 4-5 February 2016 at the OECD Conference Centre in Paris.
This presentation by Mark BLECHER was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
Accelerating Progress towards Universal Health Coverage (UHC) H.E. Anutin Charnvirakul
Deputy Prime Minister and Minister of Public Health, Thailand
Prince Mahidol Award Conference, 31 January 2020, Bangkok, Thailand
Presentation delivered by Dr Zsuzsanna Jakab, Regional Director WHO Europe, at the international health forum (Ashgabat, Turkmenistan, 21-22 July 2015)
Jussi Tervola, Susanna Mukkila, Katja Ilmarinen ja Satu Kapiainen: The effect...THL
Jussi Tervola, Susanna Mukkila, Katja Ilmarinen ja Satu Kapiainen. Workshop: Projecting population health and care needs using population survey and register data. 17.9.2018.
This presentation by Akiko MAEDA and Cheryl CASHIN was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Camila VAMMALLE and Claudia HULBERTOECD Governance
This presentation by Camila VAMMALLE and Claudia HULBERT was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Mads Bager HOFFMANNOECD Governance
This presentation by Mads Bager HOFFMANN was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
This presentation by Ankit KUMAR was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
Ageing: Fiscal implications and policy responses -- John Beard, World Health ...OECD Governance
This presentation was made by John Beard, WHO, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
The fiscal sustainability of long-term care and its impact on health systems ...OECD Governance
This presentation was made by Tim Muir, OECD, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Ageing: Fiscal implications and policy responses -- Mirko Lichetta, United Ki...OECD Governance
This presentation was made by Mirko Lichetta, United Kingdom, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Structure and governance of financing - Tamas Evetovits, WHOOECD Governance
This presentation was made by Tamas Evetovits, WHO, at the 2nd Health Systems joint Network Meeting for Central, Eastern and Southeastern European Countries held in Tallinn, Estonia, on 1-2 December 2016
This presentation by Sarah THOMSON was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
This presentation was made by Tamas EVETOVITS, WHO Barcelona Office, at the 5th Meeting of the joint OECD DELSA/GOV Network on Fiscal Sustainability of Health Systems held on 4-5 February 2016 at the OECD Conference Centre in Paris.
This presentation by Mark BLECHER was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
Accelerating Progress towards Universal Health Coverage (UHC) H.E. Anutin Charnvirakul
Deputy Prime Minister and Minister of Public Health, Thailand
Prince Mahidol Award Conference, 31 January 2020, Bangkok, Thailand
Presentation delivered by Dr Zsuzsanna Jakab, Regional Director WHO Europe, at the international health forum (Ashgabat, Turkmenistan, 21-22 July 2015)
Jussi Tervola, Susanna Mukkila, Katja Ilmarinen ja Satu Kapiainen: The effect...THL
Jussi Tervola, Susanna Mukkila, Katja Ilmarinen ja Satu Kapiainen. Workshop: Projecting population health and care needs using population survey and register data. 17.9.2018.
This presentation by Akiko MAEDA and Cheryl CASHIN was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Camila VAMMALLE and Claudia HULBERTOECD Governance
This presentation by Camila VAMMALLE and Claudia HULBERT was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Mads Bager HOFFMANNOECD Governance
This presentation by Mads Bager HOFFMANN was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
This presentation by Ankit KUMAR was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Bogart MONTIEL REYNAOECD Governance
This presentation by Bogart MONTIEL REYNA was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Christian KASTROPOECD Governance
This presentation by Christian KASTROP was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Barbara UBALDIOECD Governance
This presentation by Barbara UBALDI was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
DELSA/GOV 3rd Health meeting - Franck VON LENNEPOECD Governance
This presentation by Franck VON LENNEP was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
Presentation delivered by Dr Zsuzsanna Jakab, WHO Regional Director for Europe, at the Advanced Training and Conference on Health Economics (24 June 2015, Budapest, Hungary)
Contemporary health policy context in Europe: some opportunities and challenges
Presentation by Dr Zsuzsanna Jakab, WHO Regional Director for Europe. 8 March 2017, Israel
Delivered at the WHO Advanced Course on Health Financing for UHC in Low and MIddle Income Countries, this presentation reviews one of the core functions of health financing policy, namely raising for health services.
Mobilizing Domestic Resources for Universal Health Coverage by Dr. Ngozi Okon...Ngozi Okonjo-Iweala
Keynote Address Delivered by Dr. Ngozi Okonjo-Iweala, Chair of the Board of Gavi, the Vaccine Alliance at The First Universal Health Coverage Financing Forum Organised by the World Bank Group, and USAID Attended by Health and Finance Ministers and Health Experts.
Health Financing Functions: Risk PoolingHFG Project
Presentation by Dr. Elaine Baruwa, Abt Associates, at Haiti's International Conference on Access to Health Care for All in Haiti: Challenges and Perspectives for Funding, April 28-29, 2015, Haïti
This presentation was made by at the 3rd Health Systems Joint Network meeting for Central, Eastern and South-eastern European Countries held in Vilnius, Lithuania, on 25-26 April 2019
Prompted by the 20th anniversary of the 1993 World Development Report, a Lancet Commission revisited the case for investment in health and developed a new investment frame work to achieve dramatic health gains by 2035. Our report has four key messages, each accompanied by opportunities for action by national governments of low-income and middle-income countries and by the international community.
The value of health to an economy is hard to quantify, but its importance is undeniable. A population’s health plays a key role in economic progress, and in coming years healthcare will be a key area of focus for policymakers, payers,providers and the public alike. Financing the future: Choices and challenges in global health studies the role of healthcare against a backdrop of changing demographic patterns, rising healthcare costs and technological innovation.
Sustainability and transition - Nicolas Cantau, The Global FundOECD Governance
This presentation was made by Nicolas Cantau, The Global Fund, at the 2nd Health Systems Joint Network Meeting for Central, Eastern and Southeastern European Countries held in Tallinn, Estonia, on 1-2 December 2016
Summary of the OECD expert meeting: Construction Risk Management in Infrastru...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Using AI led assurance to deliver projects on time and on budget - D. Amratia...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
ECI in Sweden - A. Kadefors, KTH Royal Institute of Technology, Stockholm (SE)OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Building Client Capability to Deliver Megaprojects - J. Denicol, professor at...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Procurement strategy in major infrastructure: The AS-IS and STEPS - D. Makovš...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Procurement of major infrastructure projects 2017-22 - B. Hasselgren, Senior ...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
ECI Dutch Experience - A. Chao, Partner, Bird&Bird & J. de Koning, Head of Co...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
ECI in Sweden - A. Kadefors, KTH Royal Institute of Technology, StockholmOECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
EPEC's perception of market developments - E. Farquharson, Principal Adviser,...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Geographical scope of the lines in Design and Build - B.Dupuis, Executive Dir...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Executive Agency of the Dutch Ministry of Infrastructure and Water Management...OECD Governance
Presented at the OECD expert meeting "Construction Risk Management in Infrastructure Procurement: The Loss of Appetite for Fixed-Price Contracts", held on 17 May 2023 at the OECD, Paris and online.
Presentation of OECD Government at a Glance 2023OECD Governance
Paris, 30 June, 2023
Presentation by Elsa Pilichowski, Director for Public Governance, OECD.
The 2023 edition of Government at a Glance provides a comprehensive overview of public governance and public administration practices in OECD Member and partner countries. It includes indicators on trust in public institutions and satisfaction with public services, as well as evidence on good governance practices in areas such as the policy cycle, budgeting, procurement, infrastructure planning and delivery, regulatory governance, digital government and open government data. Finally, it provides information on what resources public institutions use and how they are managed, including public finances, public employment, and human resources management. Government at a Glance allows for cross-country comparisons and helps identify trends, best practices, and areas for improvement in the public sector.
See: https://www.oecd.org/publication/government-at-a-glance/2023/
The Protection and Promotion of Civic Space: Strengthening Alignment with Int...OECD Governance
Infographics from the OECD report "The Protection and Promotion of Civic Space Strengthening Alignment with International Standards and Guidance".
See: https://www.oecd.org/gov/the-protection-and-promotion-of-civic-space-d234e975-en.htm
OECD Publication "Building Financial Resilience
to Climate Impacts. A Framework for Governments to manage the risks of Losses and Damages.
Governments are facing significant climate-related risks from the expected increase in frequency and intensity of cyclones, floods, fires, and other climate-related extreme events. The report Building Financial Resilience to Climate Impacts: A Framework for Governments to Manage the Risks of Losses and Damages provides a strategic framework to help governments, particularly those in emerging market and developing economies, strengthen their capacity to manage the financial implications of climate-related risks. Published in December 2022.
OECD presentation "Strengthening climate and environmental considerations in infrastructure and budget appraisal tools"
by Margaux Lelong and Ana Maria Ruiz during the 9th Meeting of the OECD Paris Collaborative on Green Budgeting held on 17 and 18 of April 2023 in Paris.
OECD presentation "Building Financial Resilience to Climate Impacts. A Framework to Manage the Risks of Losses and Damages" by Andrew Blazey, Stéphane Jacobzone and Titouan Chassagne. Presented during the 9th Meeting of the OECD Paris Collaborative on Green Budgeting held on 17 and 18 of April 2023 in Paris
OECD Presentation "Financial reporting, sustainability information and assurance" by Peter Welch during the 5th Session during the 9th Meeting of the OECD Paris Collaborative on Green Budgeting held on 17 and 18 of April 2023 in Paris
Presentation "Developments in sovereign green bond markets" by Ms. Fatos Koc during the 4th Session of 9th Meeting of the OECD Paris Collaborative on Green Budgeting held on 17 and 18 of April 2023 in Paris.
Understanding the Challenges of Street ChildrenSERUDS INDIA
By raising awareness, providing support, advocating for change, and offering assistance to children in need, individuals can play a crucial role in improving the lives of street children and helping them realize their full potential
Donate Us
https://serudsindia.org/how-individuals-can-support-street-children-in-india/
#donatefororphan, #donateforhomelesschildren, #childeducation, #ngochildeducation, #donateforeducation, #donationforchildeducation, #sponsorforpoorchild, #sponsororphanage #sponsororphanchild, #donation, #education, #charity, #educationforchild, #seruds, #kurnool, #joyhome
What is the point of small housing associations.pptxPaul Smith
Given the small scale of housing associations and their relative high cost per home what is the point of them and how do we justify their continued existance
A process server is a authorized person for delivering legal documents, such as summons, complaints, subpoenas, and other court papers, to peoples involved in legal proceedings.
Presentation by Jared Jageler, David Adler, Noelia Duchovny, and Evan Herrnstadt, analysts in CBO’s Microeconomic Studies and Health Analysis Divisions, at the Association of Environmental and Resource Economists Summer Conference.
Russian anarchist and anti-war movement in the third year of full-scale warAntti Rautiainen
Anarchist group ANA Regensburg hosted my online-presentation on 16th of May 2024, in which I discussed tactics of anti-war activism in Russia, and reasons why the anti-war movement has not been able to make an impact to change the course of events yet. Cases of anarchists repressed for anti-war activities are presented, as well as strategies of support for political prisoners, and modest successes in supporting their struggles.
Thumbnail picture is by MediaZona, you may read their report on anti-war arson attacks in Russia here: https://en.zona.media/article/2022/10/13/burn-map
Links:
Autonomous Action
http://Avtonom.org
Anarchist Black Cross Moscow
http://Avtonom.org/abc
Solidarity Zone
https://t.me/solidarity_zone
Memorial
https://memopzk.org/, https://t.me/pzk_memorial
OVD-Info
https://en.ovdinfo.org/antiwar-ovd-info-guide
RosUznik
https://rosuznik.org/
Uznik Online
http://uznikonline.tilda.ws/
Russian Reader
https://therussianreader.com/
ABC Irkutsk
https://abc38.noblogs.org/
Send mail to prisoners from abroad:
http://Prisonmail.online
YouTube: https://youtu.be/c5nSOdU48O8
Spotify: https://podcasters.spotify.com/pod/show/libertarianlifecoach/episodes/Russian-anarchist-and-anti-war-movement-in-the-third-year-of-full-scale-war-e2k8ai4
ZGB - The Role of Generative AI in Government transformation.pdfSaeed Al Dhaheri
This keynote was presented during the the 7th edition of the UAE Hackathon 2024. It highlights the role of AI and Generative AI in addressing government transformation to achieve zero government bureaucracy
1. Division of Health Systems & Public Health
Fiscal sustainability and
sustainable public financing
for health
Dr Tamás Evetovits
Sr Health Financing Specialist & Head of Office a.i.
WHO Barcelona Office
OECD meeting of the Joint Network on Fiscal
Sustainability of Health Systems, 24-25 April 2014
2. Let’s get the concept and the objectives
right
Reality check on health spending and its fiscal
impact
Sustainable public financing for health
Outline
3. An accounting exercise
or
a matter of choice in
public policy priorities
and finding the right
instruments to minimize
adverse effects on
health, equity and
financial protection?
Fiscal sustainability of health systems
4. Fiscal sustainability is meaningless if not
linked to public policy objectives
• Fiscal sustainability should
not be seen as a policy
objective worth pursuing
for its own sake…
• …if it was an objective,
then a simple cost cutting
exercise would do the
job…
• … and both equity and
efficiency would suffer
• Fiscal sustainability should
be treated as a constraint
that has to be respected by
all sectors of public financing
• Continual increase of
government debt is bad
policy and not in the interest
of future generations…
• …because both equity and
efficiency would suffer
5. Fiscal sustainability: a slippery concept
• It applies at the level of overall public spending
(overall fiscal balance)
• At a sectoral (e.g. health) level, the concept is
less clear
– How much gets spent depends on a country’s overall
fiscal context and the priority that government gives to
each sector in its budget
– So the impact of the health sector on “fiscal
sustainability” depends in part on choice
6. There is nothing wrong with health
expenditure growing faster than GDP
As long as…
• other sectors are not growing that fast
(no fiscal imbalance)
• spending is efficient (welfare enhancing)
• people prefer to spend the additional
wealth on health (THEY DO!)
7. Health is the top priority for more public spending
across Europe
0
204060
Health Education Pensions Assisting poor Housing Infrastructure Environment
First priority Second priority
Source: Life in transition survey 2010, EBRD
9. Health spending increased, but did not carve out an unfair
share of growing public spending in the previous decade
Source: WHO NHA database, 2012
12.9%12.1%
10. And this relative increase has faded
away in the past 10 years (2003-2012)
12.5% 12.7%12.5% 12.7%
12.5% 12.7%
12.5% 12.7%
Source: WHO, 2014
11. While health has been taking a greater share of public
spending in high income countries pre-crisis, it is not the case
in less developed countries of the WHO European Region
Source: WHO NHA database, 2012
14.4%13.7%
12. The health sector is certainly not a threat to
fiscal sustainability in Hungary…
13. …or in Malta where health just started
to catch up
19. Insurance function and public financing
• Let’s not forget the primary reason why health
is a big ticket item on the public budget
• Public financing achieves better financial
protection and equity in access to care i.e.
health insurance according to need and not
according to ability to pay
• User charges do not provide financial risk
protection…or equity… and not even
efficiency or cost control
20. Public spending is growing only in high income
countries: closing the gap in a generation?
22. Unmet need in the poorest quintile
Source: EU SILC
0
5
10
15
20
25
30
2007 2008 2009 2010 2011
%ofpopulationin(poorestquintile)
Latvia
Romania
Italy
Greece
Iceland
EU (27
countries)
Hungary
Belgium
Spain
How much inequity is “sustainable” in Latvia?
23. In contrast, counter-cyclical public spending at
work in Lithuania
23
0
500
1,000
1,500
2,000
2,500
3,000
3,500
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
planas
2013 m.
projektas
Total amount of contributions of economically active population, million LTL
Total amount of contributions and aditional allocations of national budget, million LTL
mln.Lt
Source: G. Kacevicius
24. Avoiding unproductive cost escalation is our joint
responsibility: some good options
Reduce variation, inappropriate utilization of
services through supply side measures
Improve rational drug use and price control.
Careful with new drugs of marginal benefits
Allocate more to primary and outpatient
specialist care at the expense of hospitals
Invest in infrastructure (including IT) that is
less costly to operate
25. Avoiding unproductive cost escalation is our joint
responsibility: some bad options
Shifting costs to patients
Under-providing health services
Spending less on cost-effective services by
cutting across the board
Leaving it to the doctors to decide and pay
them fee-for-service
26. In summary
Health is highly valued
by population:
spending above GDP
growth can be justified
Public spending on
health needs to grow
in low and middle
income countries
Unproductive cost
escalation should be
avoided, but cutting
spending ≠ efficiency
Shifting the burden to
patients is a poor
alternative to many
other options