This presentation was made by Thomas Brändle and Carsten Colombier, Switzerland, 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.
Federal health care spending is growing faster than both the economy and other areas of federal spending due to three main factors: population aging, expansion of federal subsidies for health insurance through the Affordable Care Act, and rising health care costs per person. While population aging cannot be addressed, lawmakers could roll back the ACA's expansion of coverage or reduce federal subsidies to lower spending. CBO analyzed options like repealing the ACA, limiting exchange subsidies, and increasing Medicare premiums that could significantly reduce spending. Addressing rising health care costs per person will also be important to control long-term spending growth.
The document discusses how the Congressional Budget Office (CBO) uses analytic models and communicates its findings. The CBO provides objective analysis to Congress on budgets, spending, revenues, and legislation. It uses various types of models like spreadsheets, regression, and microsimulation to make projections. The CBO evaluates evidence, consults experts, and reviews its models. It disseminates methods, findings, and answers through reports, working papers, meetings, and visualizations to facilitate understanding.
The federal budget deficit grew during the 2008-2009 recession and remained larger in 2013 than in 2008, amounting to $680 billion or 4.1% of GDP. Federal spending was 20.8% of GDP in 2013, slightly above the 40-year average, while revenues were 16.7% of GDP. Large budget deficits in recent years substantially increased federal debt held by the public to 72% of GDP in 2013, the highest level in over 60 years, which could negatively impact long-term economic growth.
The Congressional Budget Office (CBO) estimates the budgetary impacts of prevention policies by:
1) Establishing baselines for health risks, spending, and outcomes and projecting them over time.
2) Estimating behavioral responses to policies and how these affect health.
3) Calculating how changes in health, spending, and the economy feedback into federal spending and revenues over decades.
The CBO uses this framework to analyze policies like cigarette taxes, estimating long-term effects on outcomes like longevity, spending, the deficit, and challenges in the evidence.
The document summarizes a Congressional Budget Office report on the distribution of federal spending and taxes in 2006. It finds that in 2006:
- Federal spending totaled $2.7 trillion while revenues were $2.4 trillion. Spending primarily went to cash/near-cash transfers, health care transfers, and other goods/services.
- Elderly households received more in transfers than they paid in taxes, while non-elderly households paid more in taxes than they received in transfers and other spending.
- Among non-elderly households, lower income groups received more in transfers than they paid in taxes, while higher income groups paid more in taxes than they received in transfers and other federal spending
This document summarizes federal discretionary spending in the United States in 2013. It shows that discretionary spending totaled $1.2 trillion, or 7.2% of GDP, with national defense accounting for $626 billion, the largest portion. On average between 1993 and 2012, discretionary spending was 3.5% of GDP. The document provides a breakdown of discretionary spending by category in 2013, with the largest categories being national defense, healthcare, income security, and veterans' benefits.
Presentation at the Fifth Biennial Conference of the American Society of Health Economists, by Allison Percy, Health, Retirement, and Long-Term Analysis Division
Presentation by James Baumgardner, Ph.D., Deputy Assistant Director Health, Retirement, and Long-Term Analysis Division, CBO, to the 30th International Congress of Actuaries on April 4, 2014
This presentation provides information published in Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget (June 2012), www.cbo.gov/publication/43319
Federal health care spending is growing faster than both the economy and other areas of federal spending due to three main factors: population aging, expansion of federal subsidies for health insurance through the Affordable Care Act, and rising health care costs per person. While population aging cannot be addressed, lawmakers could roll back the ACA's expansion of coverage or reduce federal subsidies to lower spending. CBO analyzed options like repealing the ACA, limiting exchange subsidies, and increasing Medicare premiums that could significantly reduce spending. Addressing rising health care costs per person will also be important to control long-term spending growth.
The document discusses how the Congressional Budget Office (CBO) uses analytic models and communicates its findings. The CBO provides objective analysis to Congress on budgets, spending, revenues, and legislation. It uses various types of models like spreadsheets, regression, and microsimulation to make projections. The CBO evaluates evidence, consults experts, and reviews its models. It disseminates methods, findings, and answers through reports, working papers, meetings, and visualizations to facilitate understanding.
The federal budget deficit grew during the 2008-2009 recession and remained larger in 2013 than in 2008, amounting to $680 billion or 4.1% of GDP. Federal spending was 20.8% of GDP in 2013, slightly above the 40-year average, while revenues were 16.7% of GDP. Large budget deficits in recent years substantially increased federal debt held by the public to 72% of GDP in 2013, the highest level in over 60 years, which could negatively impact long-term economic growth.
The Congressional Budget Office (CBO) estimates the budgetary impacts of prevention policies by:
1) Establishing baselines for health risks, spending, and outcomes and projecting them over time.
2) Estimating behavioral responses to policies and how these affect health.
3) Calculating how changes in health, spending, and the economy feedback into federal spending and revenues over decades.
The CBO uses this framework to analyze policies like cigarette taxes, estimating long-term effects on outcomes like longevity, spending, the deficit, and challenges in the evidence.
The document summarizes a Congressional Budget Office report on the distribution of federal spending and taxes in 2006. It finds that in 2006:
- Federal spending totaled $2.7 trillion while revenues were $2.4 trillion. Spending primarily went to cash/near-cash transfers, health care transfers, and other goods/services.
- Elderly households received more in transfers than they paid in taxes, while non-elderly households paid more in taxes than they received in transfers and other spending.
- Among non-elderly households, lower income groups received more in transfers than they paid in taxes, while higher income groups paid more in taxes than they received in transfers and other federal spending
This document summarizes federal discretionary spending in the United States in 2013. It shows that discretionary spending totaled $1.2 trillion, or 7.2% of GDP, with national defense accounting for $626 billion, the largest portion. On average between 1993 and 2012, discretionary spending was 3.5% of GDP. The document provides a breakdown of discretionary spending by category in 2013, with the largest categories being national defense, healthcare, income security, and veterans' benefits.
Presentation at the Fifth Biennial Conference of the American Society of Health Economists, by Allison Percy, Health, Retirement, and Long-Term Analysis Division
Presentation by James Baumgardner, Ph.D., Deputy Assistant Director Health, Retirement, and Long-Term Analysis Division, CBO, to the 30th International Congress of Actuaries on April 4, 2014
This presentation provides information published in Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget (June 2012), www.cbo.gov/publication/43319
Mandatory spending in the US federal budget in 2013 totaled $2.0 trillion, or 12.2% of GDP. The largest portions were $861 billion on major health care programs like Medicare and Medicaid, $808 billion on Social Security, and $340 billion on income security programs. Mandatory spending has increased as a percentage of GDP from 10.6% in 1993 due to growth in major health care programs and income security programs.
This infographic provides an overview of CBO's report, The 2016 Long-Term Budget Outlook. Gain quick insight into why CBO projects a substantial imbalance in the federal budget beyond the next 10 years.
The Congressional Budget Office document analyzes the effects of raising the federal excise tax on cigarettes by 50 cents. It finds that such a policy would:
1) Reduce the number of smokers by over 2 million people by 2034 and improve health outcomes by lowering mortality and healthcare spending.
2) Increase federal revenues from the higher tax and decrease spending on federal health programs like Medicare and Medicaid due to the health improvements.
3) Positively impact the federal budget over both the 10-year budget window and longer-term through the above effects on revenues, outlays, and population.
Douglas Elmendorf, director of the Congressional Budget Office, presented CBO's economic outlook. CBO projects that the labor market recovery will continue slowly as structural issues and long-term unemployment impact participation rates. Potential GDP growth is estimated to average 2.1% through 2024 while actual GDP growth is projected to average 2.5% as the output gap closes. Inflation and interest rates are expected to remain low. The budget deficit is projected to decline but debt held by the public will continue rising as a share of GDP.
The document summarizes CBO's use of evidence in analyzing budget and economic policies. CBO provides objective analysis to Congress on various topics, including federal spending, revenues, and the effects of legislation. CBO uses a range of evidence from research studies, data, and expert consultation to make projections and cost estimates. CBO aims to characterize the uncertainty around estimates and clearly explain its analytical methods and use of evidence.
The Congressional Budget Office director presented on the current outlook for the federal budget and criteria for evaluating policy changes. Under current law, deficits will remain high and debt will exceed historical averages. Fundamental choices are needed as federal health and retirement programs grow substantially due to an aging population. To adequately reduce deficits, large cuts would be needed to spending programs, substantial tax increases, or a combination. Any policy changes involve economic and distributional tradeoffs to consider.
This document summarizes a presentation by the Congressional Budget Office (CBO) director on federal health care spending growth and potential policy options. The CBO provides nonpartisan analysis to Congress. Federal health spending is growing faster than other spending and the economy due to population aging, expanded insurance subsidies, and rising per person costs. The Affordable Care Act will significantly reduce the uninsured but have little effect on most with coverage. Improving health, reducing subsidies, changing payments, and restructuring programs could help budgets but have various effects on different groups.
This document from the Congressional Budget Office provides additional information on CBO's 2013 long-term projections for Social Security. It finds that:
- Social Security outlays exceeded tax revenues for the first time in 2010 and CBO projects the gap will average 12% of tax revenues over the next decade as more baby boomers retire.
- The Disability Insurance trust fund is projected to be exhausted in 2017 and the Old-Age and Survivors Insurance trust fund in 2033, though combining the two the funds would be exhausted in 2031.
- The amount of taxes paid and benefits received through Social Security varies between groups based on earnings, with higher earners paying more in taxes but receiving proportionately lower replacement rates
NHS finances: the challenge all political parties need to face - updated tabl...The Health Foundation
View the full set of charts and tables from our 2015 briefing 'NHS finances: the challenge all political parties need to face' - some of the data was updated in May 2015 and this slidepack reflects those updates.
CBO projects that federal spending on the major health care programs would grow larger than spending in any other category if current laws generally remained unchanged. Spending on those programs would account for 40 percent of federal noninterest spending in 2047, compared with 28 percent today. Two factors explain the projected growth in spending on major health care programs: aging and rising health care costs per person (also known as excess cost growth).
Presentation by Keith Hall, CBO Director, to the Council for Affordable Health Coverage and the American Action Forum.
This document summarizes how the Congressional Budget Office prepares long-term projections of federal spending on Social Security and major health care programs like Medicare and Medicaid. CBO uses an actuarial model to project spending for these programs based on historical trends in health care cost growth, population growth, and economic growth. CBO assumes the rate of excess health care cost growth will decline gradually over time to prevent unsustainably high projections of future spending.
The Congressional Budget Office document analyzes the distribution of federal spending and taxes in the United States in 2006. It finds that in 2006, federal spending exceeded taxes paid for elderly households, while taxes exceeded spending for non-elderly households. Among non-elderly households, federal spending was higher than taxes paid for lower-income households, while taxes exceeded spending for higher-income households.
Presentation by Heidi Golding, an analyst in CBO’s National Security Division, at the Southern Economic Association Annual Meeting.
In this presentation, CBO provides background information on the VA health care system and past spending and describes 10-year projections by CBO on VA health spending under three different scenarios. CBO finds that, under certain assumptions, future spending required to treat veterans may be substantially higher (in inflation-adjusted dollars) than recent appropriations.
Presentation by Kathleen Burke, John McClelland, and Jennifer Shand, analysts in CBO’s Tax Analysis Division, to the National Association of Legislative Fiscal Offices.
This document summarizes a Congressional Budget Office presentation on exploring the growth of Medicaid managed care. It finds that while Medicaid managed care enrollment has grown significantly, spending attributed to managed care has grown even more. It also finds variation between states in how they structure their managed care programs and which eligibility groups and services they cover through managed care. The presentation aims to improve understanding of whether managed care is the predominant delivery system and to inform expectations for its future growth.
If current laws governing taxes and spending did not change, the condition of the federal budget would worsen considerably over the next three decades. Growth in federal spending would continue to outpace growth in federal revenues, leading to ever-larger budget deficits.
CBO projects that federal spending on the major health care programs would grow larger than spending in any other category if current laws generally remained unchanged. Driven particularly by growth in Medicare outlays, spending on those programs would account for 40 percent of federal noninterest spending in 2047, compared with 28 percent today. Two factors explain the projected growth in spending on major health care programs: aging of the population and rising health care costs per person (that is, excess cost growth).
Presentation by Jessica Banthin, Deputy Assistant Director in CBO’s Health, Retirement, and Long-Term Analysis Division, at a conference organized by the Center for Sustainable Health Spending.
Douglas Elmendorf, the Director of the Congressional Budget Office, presented on the shifting priorities in the federal budget under current law. He noted that federal debt will be much larger relative to GDP than in history and spending on benefits for older Americans and healthcare will rise substantially while other spending falls. By 2020, spending on Social Security and major healthcare programs will be 50% larger than the past 40 years average while all other spending will be at its lowest level in over 70 years. This unsustainable path will require cutting benefits, raising taxes, or a combination of both.
Presentation by Keith Hall, CBO Director, to the American Academy of Actuaries.
In fiscal year 2016, the federal budget deficit increased, in relation to the size of the economy, for the first time since 2009, according to the Congressional Budget Office’s estimates. If current laws generally remained unchanged, the deficit would grow over the next 10 years, and by 2026 it would be considerably larger than its average over the past 50 years, CBO projects. Debt held by the public would also grow significantly from its already high level.
To analyze the state of the budget in the long term, CBO has extrapolated its 10-year baseline projections an additional two decades. If current laws governing taxes and spending remain in place, the outlook for the budget would steadily worsen over the long term, with revenues falling well short of spending. In those projections, federal debt held by the public rises to 141 percent of GDP in 2046.
To put the federal budget on a sustainable path for the long term, lawmakers would have to make major changes to tax policies, spending policies, or both – by reducing spending for large benefit programs below the projected amounts, letting revenues rise more than they would under current law, or adopting some combination of those approaches. The size of such changes would depend on the amount of federal debt that lawmakers considered appropriate.
Ageing - Fiscal implications and policy responses - Mirko Licchetta, United K...OECD Governance
This presentation was made by Mirko Licchetta, United Kingdom, at the 6th meeting of the joint OECD DELSA-GOV network on fiscal sustainability of health systems held in Paris, on 18-19 September 2017
Mandatory spending in the US federal budget in 2013 totaled $2.0 trillion, or 12.2% of GDP. The largest portions were $861 billion on major health care programs like Medicare and Medicaid, $808 billion on Social Security, and $340 billion on income security programs. Mandatory spending has increased as a percentage of GDP from 10.6% in 1993 due to growth in major health care programs and income security programs.
This infographic provides an overview of CBO's report, The 2016 Long-Term Budget Outlook. Gain quick insight into why CBO projects a substantial imbalance in the federal budget beyond the next 10 years.
The Congressional Budget Office document analyzes the effects of raising the federal excise tax on cigarettes by 50 cents. It finds that such a policy would:
1) Reduce the number of smokers by over 2 million people by 2034 and improve health outcomes by lowering mortality and healthcare spending.
2) Increase federal revenues from the higher tax and decrease spending on federal health programs like Medicare and Medicaid due to the health improvements.
3) Positively impact the federal budget over both the 10-year budget window and longer-term through the above effects on revenues, outlays, and population.
Douglas Elmendorf, director of the Congressional Budget Office, presented CBO's economic outlook. CBO projects that the labor market recovery will continue slowly as structural issues and long-term unemployment impact participation rates. Potential GDP growth is estimated to average 2.1% through 2024 while actual GDP growth is projected to average 2.5% as the output gap closes. Inflation and interest rates are expected to remain low. The budget deficit is projected to decline but debt held by the public will continue rising as a share of GDP.
The document summarizes CBO's use of evidence in analyzing budget and economic policies. CBO provides objective analysis to Congress on various topics, including federal spending, revenues, and the effects of legislation. CBO uses a range of evidence from research studies, data, and expert consultation to make projections and cost estimates. CBO aims to characterize the uncertainty around estimates and clearly explain its analytical methods and use of evidence.
The Congressional Budget Office director presented on the current outlook for the federal budget and criteria for evaluating policy changes. Under current law, deficits will remain high and debt will exceed historical averages. Fundamental choices are needed as federal health and retirement programs grow substantially due to an aging population. To adequately reduce deficits, large cuts would be needed to spending programs, substantial tax increases, or a combination. Any policy changes involve economic and distributional tradeoffs to consider.
This document summarizes a presentation by the Congressional Budget Office (CBO) director on federal health care spending growth and potential policy options. The CBO provides nonpartisan analysis to Congress. Federal health spending is growing faster than other spending and the economy due to population aging, expanded insurance subsidies, and rising per person costs. The Affordable Care Act will significantly reduce the uninsured but have little effect on most with coverage. Improving health, reducing subsidies, changing payments, and restructuring programs could help budgets but have various effects on different groups.
This document from the Congressional Budget Office provides additional information on CBO's 2013 long-term projections for Social Security. It finds that:
- Social Security outlays exceeded tax revenues for the first time in 2010 and CBO projects the gap will average 12% of tax revenues over the next decade as more baby boomers retire.
- The Disability Insurance trust fund is projected to be exhausted in 2017 and the Old-Age and Survivors Insurance trust fund in 2033, though combining the two the funds would be exhausted in 2031.
- The amount of taxes paid and benefits received through Social Security varies between groups based on earnings, with higher earners paying more in taxes but receiving proportionately lower replacement rates
NHS finances: the challenge all political parties need to face - updated tabl...The Health Foundation
View the full set of charts and tables from our 2015 briefing 'NHS finances: the challenge all political parties need to face' - some of the data was updated in May 2015 and this slidepack reflects those updates.
CBO projects that federal spending on the major health care programs would grow larger than spending in any other category if current laws generally remained unchanged. Spending on those programs would account for 40 percent of federal noninterest spending in 2047, compared with 28 percent today. Two factors explain the projected growth in spending on major health care programs: aging and rising health care costs per person (also known as excess cost growth).
Presentation by Keith Hall, CBO Director, to the Council for Affordable Health Coverage and the American Action Forum.
This document summarizes how the Congressional Budget Office prepares long-term projections of federal spending on Social Security and major health care programs like Medicare and Medicaid. CBO uses an actuarial model to project spending for these programs based on historical trends in health care cost growth, population growth, and economic growth. CBO assumes the rate of excess health care cost growth will decline gradually over time to prevent unsustainably high projections of future spending.
The Congressional Budget Office document analyzes the distribution of federal spending and taxes in the United States in 2006. It finds that in 2006, federal spending exceeded taxes paid for elderly households, while taxes exceeded spending for non-elderly households. Among non-elderly households, federal spending was higher than taxes paid for lower-income households, while taxes exceeded spending for higher-income households.
Presentation by Heidi Golding, an analyst in CBO’s National Security Division, at the Southern Economic Association Annual Meeting.
In this presentation, CBO provides background information on the VA health care system and past spending and describes 10-year projections by CBO on VA health spending under three different scenarios. CBO finds that, under certain assumptions, future spending required to treat veterans may be substantially higher (in inflation-adjusted dollars) than recent appropriations.
Presentation by Kathleen Burke, John McClelland, and Jennifer Shand, analysts in CBO’s Tax Analysis Division, to the National Association of Legislative Fiscal Offices.
This document summarizes a Congressional Budget Office presentation on exploring the growth of Medicaid managed care. It finds that while Medicaid managed care enrollment has grown significantly, spending attributed to managed care has grown even more. It also finds variation between states in how they structure their managed care programs and which eligibility groups and services they cover through managed care. The presentation aims to improve understanding of whether managed care is the predominant delivery system and to inform expectations for its future growth.
If current laws governing taxes and spending did not change, the condition of the federal budget would worsen considerably over the next three decades. Growth in federal spending would continue to outpace growth in federal revenues, leading to ever-larger budget deficits.
CBO projects that federal spending on the major health care programs would grow larger than spending in any other category if current laws generally remained unchanged. Driven particularly by growth in Medicare outlays, spending on those programs would account for 40 percent of federal noninterest spending in 2047, compared with 28 percent today. Two factors explain the projected growth in spending on major health care programs: aging of the population and rising health care costs per person (that is, excess cost growth).
Presentation by Jessica Banthin, Deputy Assistant Director in CBO’s Health, Retirement, and Long-Term Analysis Division, at a conference organized by the Center for Sustainable Health Spending.
Douglas Elmendorf, the Director of the Congressional Budget Office, presented on the shifting priorities in the federal budget under current law. He noted that federal debt will be much larger relative to GDP than in history and spending on benefits for older Americans and healthcare will rise substantially while other spending falls. By 2020, spending on Social Security and major healthcare programs will be 50% larger than the past 40 years average while all other spending will be at its lowest level in over 70 years. This unsustainable path will require cutting benefits, raising taxes, or a combination of both.
Presentation by Keith Hall, CBO Director, to the American Academy of Actuaries.
In fiscal year 2016, the federal budget deficit increased, in relation to the size of the economy, for the first time since 2009, according to the Congressional Budget Office’s estimates. If current laws generally remained unchanged, the deficit would grow over the next 10 years, and by 2026 it would be considerably larger than its average over the past 50 years, CBO projects. Debt held by the public would also grow significantly from its already high level.
To analyze the state of the budget in the long term, CBO has extrapolated its 10-year baseline projections an additional two decades. If current laws governing taxes and spending remain in place, the outlook for the budget would steadily worsen over the long term, with revenues falling well short of spending. In those projections, federal debt held by the public rises to 141 percent of GDP in 2046.
To put the federal budget on a sustainable path for the long term, lawmakers would have to make major changes to tax policies, spending policies, or both – by reducing spending for large benefit programs below the projected amounts, letting revenues rise more than they would under current law, or adopting some combination of those approaches. The size of such changes would depend on the amount of federal debt that lawmakers considered appropriate.
Ageing - Fiscal implications and policy responses - Mirko Licchetta, United K...OECD Governance
This presentation was made by Mirko Licchetta, United Kingdom, at the 6th meeting of the joint OECD DELSA-GOV network on fiscal sustainability of health systems held in Paris, on 18-19 September 2017
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
National health accounts - Michael Müller, OECDOECD Governance
This presentation was made by Michael Müller, OECD, 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 document analyzes population aging and advances in medical technology as drivers of increasing healthcare expenditures in Switzerland. It finds that both factors are important cost drivers. Population aging has significantly increased per capita healthcare costs, especially for long-term care for the elderly. However, non-demographic factors like medical technology have an even greater impact on costs excluding long-term care. The author projects that population aging will add substantial budgetary pressures on public finances and health insurance in Switzerland through 2060 if costs trends continue. Policymakers need to address cost pressures from both demographic and non-demographic factors.
Presentation by Philip Ellis, CBO’s Deputy Assistant Director for Health, Retirement, and Long-Term Analysis, to staff of the U.S. Department of Commerce.
This presentation describes CBO’s general approach to policy analysis and its role in supporting the Congress; summarizes several elements of the agency’s projections of health care spending; and reviews examples of policy proposals and approaches affecting health care that CBO has analyzed recently.
Presentation by Julie Topoleski, Director of CBO’s Labor, Income Security, and Long-Term Analysis Division, at the 15th Annual Meeting of the OECD’s Working Party of Parliamentary Budget Officials and Independent Fiscal Institutions.
The document summarizes the key findings of the 2021 Ageing Report published by the European Commission and Economic Policy Committee. It notes that populations across Europe are ageing as fertility rates decline and life expectancy increases. This demographic shift will put pressure on public finances and sustainability of pension and healthcare systems. The report projects rising age-related spending across EU countries in the coming decades and analyzes the budgetary impact of population ageing on spending categories like pensions, healthcare, long-term care and education.
This presentation was made by Vlasta KOVACIC MEZEK, Slovenia, 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.
The document discusses achieving global health convergence by 2035 through increased investment in health. Three key points:
1) A "grand convergence" is achievable with targeted investments that could reduce under-5 mortality, AIDS deaths, and TB deaths to rates seen in developed countries by 2035.
2) Investing $70 billion annually could avert over 10 million deaths between 2016-2035 and yield high economic returns through gains in productivity.
3) Achieving universal health coverage through "progressive universalism" - initially focusing on essential services for infectious diseases and maternal/child health, and gradually expanding coverage of non-communicable diseases - is an efficient path to both improved health and financial risk protection.
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)
Ageing: fiscal implications and policy responses -- Chris James, OECDOECD Governance
This presentation was made by Chris James, OECD, at the 6th meeting of the joint OECD DELSA-GOV network on fiscal sustainability of health systems held in Paris, on 18-19 September 2017
Ageing: Fiscal implications and policy responses -- Chris James, OECDOECD Governance
This presentation was made by Chris James, OECD Secretariat, 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
- Current health expenditure as a share of GDP in India has remained stable at around 3.84% since 2000, with private expenditure making up around three times the share of government expenditure.
- Government spending on health as a share of total government spending averages 3%, while out-of-pocket expenditures make up around 69% of current health expenditures on average.
- In 2011, high out-of-pocket payments contributed to 17% of the population spending over 10% of their budget on health, equivalent to 216 million people, and pushed 52.5 million people below the poverty line.
This document summarizes the Congressional Budget Office's (CBO) methodology for projecting long-term spending on Medicare and Medicaid in the United States. The CBO uses a microsimulation model called CBOLT that is governed by an overarching macroeconomic model. Spending projections are based on historical trends in excess cost growth, population growth, and economic growth. The CBO assumes excess cost growth will gradually decline from 1.6 percentage points currently to 1.0 and 0 percentage points for Medicare and Medicaid respectively over 75 years.
Fiscal sustainability of health systems - Chris James & Camila Vammalle, OECDOECD Governance
This presentation was made by Chris James and Camila Vammalle, 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.
This document summarizes a presentation on healthcare reform in Ireland. It discusses the economics of healthcare and features of healthcare as a good. It provides an overview of Ireland's current health system, including categories of health access, trends in waiting times, expenditures, staffing levels, and inequalities in health outcomes related to social class and geographic area. It also examines the potential costs of implementing healthcare reform as outlined in Ireland's Sláintecare plan, estimating that an average of €1.6 billion additional annual funding would be needed through 2030. The conclusions call for principles of reform such as prioritizing equality, dismantling the two-tier system, and investing in primary care to reduce hospital visits.
This presentation to financial analysts identifies some flow-ons from the 2016 Budget, and identifies areas where private sector investment could accelerate innovation and transparency
The Czech Fiscal Council chairwoman discussed the challenges posed by COVID-19 for Czech public finances. The state budget deficit is projected to reach 5.5% of GDP in 2020 due to lost revenue and increased spending. While Czech public debt is relatively low, rising deficits could push debt levels over 20 percentage points higher than previous projections by 2027. There is also uncertainty around estimates of economic growth and output gaps used to calculate structural deficits. The council is concerned about a recent amendment weakening fiscal rules for the next seven years and risks of procyclical fiscal policy responses during the crisis. Pension reforms remain important to address long-term sustainability issues.
Similar to Determinants of public health care expenditure & fiscal sustainability - Thomas Brändle and Carsten Colombier, Switzerland (20)
The document discusses transparency and oversight of political party financing. It finds that financial contributions to political parties are not fully transparent and are still vulnerable to political and foreign influence. Additionally, financial reports from political parties are not always publicly available or submitted on time according to regulations.
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
This document discusses different construction project delivery and payment models. It begins by outlining common delivery models like design-bid-build and design-build. It then explains different payment methods that can be used like fixed price, unit prices, and cost-reimbursable. The document also discusses pricing strategies and how they relate to risk transfer between parties. It provides details on collaborative models like early contractor involvement and discusses selecting the optimal contract based on a client's project risks, desired influence, and market conditions.
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
This document discusses ECI Dutch experience with collaborative contracting. It mentions a McKinsey report from 2018 on collaborative contracting and recent developments in the field. Finally, it provides lessons learned from a project in Amsterdam called Bouwteam De Nieuwe Zijde Noord.
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
This document summarizes developments in sovereign green bond markets. It discusses approaches to incorporating environmental, social, and governance (ESG) factors into public debt management. Sovereign green bond issuance has grown significantly in both advanced and emerging economies since 2016. Green bonds make up the largest share of the labeled bond market. Major benefits of sovereign green bonds include their positive impact on creditworthiness and alignment with ESG policies. However, issuers also face challenges such as additional costs and complexity of the issuance process. Common leading practices emphasize transparency, collaboration, and commitment to reporting.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
The Antyodaya Saral Haryana Portal is a pioneering initiative by the Government of Haryana aimed at providing citizens with seamless access to a wide range of government services
AHMR is an interdisciplinary peer-reviewed online journal created to encourage and facilitate the study of all aspects (socio-economic, political, legislative and developmental) of Human Mobility in Africa. Through the publication of original research, policy discussions and evidence research papers AHMR provides a comprehensive forum devoted exclusively to the analysis of contemporaneous trends, migration patterns and some of the most important migration-related issues.
Combined Illegal, Unregulated and Unreported (IUU) Vessel List.Christina Parmionova
The best available, up-to-date information on all fishing and related vessels that appear on the illegal, unregulated, and unreported (IUU) fishing vessel lists published by Regional Fisheries Management Organisations (RFMOs) and related organisations. The aim of the site is to improve the effectiveness of the original IUU lists as a tool for a wide variety of stakeholders to better understand and combat illegal fishing and broader fisheries crime.
To date, the following regional organisations maintain or share lists of vessels that have been found to carry out or support IUU fishing within their own or adjacent convention areas and/or species of competence:
Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR)
Commission for the Conservation of Southern Bluefin Tuna (CCSBT)
General Fisheries Commission for the Mediterranean (GFCM)
Inter-American Tropical Tuna Commission (IATTC)
International Commission for the Conservation of Atlantic Tunas (ICCAT)
Indian Ocean Tuna Commission (IOTC)
Northwest Atlantic Fisheries Organisation (NAFO)
North East Atlantic Fisheries Commission (NEAFC)
North Pacific Fisheries Commission (NPFC)
South East Atlantic Fisheries Organisation (SEAFO)
South Pacific Regional Fisheries Management Organisation (SPRFMO)
Southern Indian Ocean Fisheries Agreement (SIOFA)
Western and Central Pacific Fisheries Commission (WCPFC)
The Combined IUU Fishing Vessel List merges all these sources into one list that provides a single reference point to identify whether a vessel is currently IUU listed. Vessels that have been IUU listed in the past and subsequently delisted (for example because of a change in ownership, or because the vessel is no longer in service) are also retained on the site, so that the site contains a full historic record of IUU listed fishing vessels.
Unlike the IUU lists published on individual RFMO websites, which may update vessel details infrequently or not at all, the Combined IUU Fishing Vessel List is kept up to date with the best available information regarding changes to vessel identity, flag state, ownership, location, and operations.
Preliminary findings _OECD field visits to ten regions in the TSI EU mining r...OECDregions
Preliminary findings from OECD field visits for the project: Enhancing EU Mining Regional Ecosystems to Support the Green Transition and Secure Mineral Raw Materials Supply.
Food safety, prepare for the unexpected - So what can be done in order to be ready to address food safety, food Consumers, food producers and manufacturers, food transporters, food businesses, food retailers can ...
This report explores the significance of border towns and spaces for strengthening responses to young people on the move. In particular it explores the linkages of young people to local service centres with the aim of further developing service, protection, and support strategies for migrant children in border areas across the region. The report is based on a small-scale fieldwork study in the border towns of Chipata and Katete in Zambia conducted in July 2023. Border towns and spaces provide a rich source of information about issues related to the informal or irregular movement of young people across borders, including smuggling and trafficking. They can help build a picture of the nature and scope of the type of movement young migrants undertake and also the forms of protection available to them. Border towns and spaces also provide a lens through which we can better understand the vulnerabilities of young people on the move and, critically, the strategies they use to navigate challenges and access support.
The findings in this report highlight some of the key factors shaping the experiences and vulnerabilities of young people on the move – particularly their proximity to border spaces and how this affects the risks that they face. The report describes strategies that young people on the move employ to remain below the radar of visibility to state and non-state actors due to fear of arrest, detention, and deportation while also trying to keep themselves safe and access support in border towns. These strategies of (in)visibility provide a way to protect themselves yet at the same time also heighten some of the risks young people face as their vulnerabilities are not always recognised by those who could offer support.
In this report we show that the realities and challenges of life and migration in this region and in Zambia need to be better understood for support to be strengthened and tuned to meet the specific needs of young people on the move. This includes understanding the role of state and non-state stakeholders, the impact of laws and policies and, critically, the experiences of the young people themselves. We provide recommendations for immediate action, recommendations for programming to support young people on the move in the two towns that would reduce risk for young people in this area, and recommendations for longer term policy advocacy.
Donate to charity during this holiday seasonSERUDS INDIA
For people who have money and are philanthropic, there are infinite opportunities to gift a needy person or child a Merry Christmas. Even if you are living on a shoestring budget, you will be surprised at how much you can do.
Donate Us
https://serudsindia.org/how-to-donate-to-charity-during-this-holiday-season/
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Contributi dei parlamentari del PD - Contributi L. 3/2019Partito democratico
DI SEGUITO SONO PUBBLICATI, AI SENSI DELL'ART. 11 DELLA LEGGE N. 3/2019, GLI IMPORTI RICEVUTI DALL'ENTRATA IN VIGORE DELLA SUDDETTA NORMA (31/01/2019) E FINO AL MESE SOLARE ANTECEDENTE QUELLO DELLA PUBBLICAZIONE SUL PRESENTE SITO
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
UN WOD 2024 will take us on a journey of discovery through the ocean's vastness, tapping into the wisdom and expertise of global policy-makers, scientists, managers, thought leaders, and artists to awaken new depths of understanding, compassion, collaboration and commitment for the ocean and all it sustains. The program will expand our perspectives and appreciation for our blue planet, build new foundations for our relationship to the ocean, and ignite a wave of action toward necessary change.
Awaken new depths - World Ocean Day 2024, June 8th.
Determinants of public health care expenditure & fiscal sustainability - Thomas Brändle and Carsten Colombier, Switzerland
1. Federal Department of Finance FDF
Federal Finance Administration FFA
Determinants of Public Health Care
Expenditure & Fiscal Sustainability
Network Fiscal Sustainability of Health Systems,
OECD, Paris, February 2015
Thomas Brändle* & Carsten Colombier**
Swiss Federal Department of Finance (FFA)
*University of Basel, Faculty of Business and Economics.
**FiFo – Institute for Public Economics, University of Cologne.
2. 2
Federal Department of Finance FDF
Federal Finance Administration FFA
Motivation
Swiss healthcare expenditure from 1960 to 2012 (in GDP %)
• Expenditure share government & mandatory healthcare
insurance: about 60%
• Public expenditure share in total healthcare expenditure is about 30%
• Cantonal expenditure share in public healthcare expenditure is about
66%
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
1960
1962
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
3. 3
Federal Department of Finance FDF
Federal Finance Administration FFA
Outline
• What are the determinants of cantonal public
health care expenditure between 1970-2012?
Panel data analysis for Swiss cantons
• How will public healthcare expenditure be
affected by population ageing and non-
demographic cost drivers until 2060?
Long-term projections
• Which are the implications for assessing fiscal
sustainability?
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
4. Federal Department of Finance FDF
Federal Finance Administration FFA
What are the determinants of cantonal
healthcare expenditure between 1970-
2012?
Panel data analysis for Swiss cantons
5. 5
Federal Department of Finance FDF
Federal Finance Administration FFA
Determinants of public health care
expenditure
• Panel dataset for all 26 Swiss cantons between 1970 and 2012.
• Dynamic bias-corrected LSDV estimator (Bruno 2005):
• Demand-side
GDP per capita and unemployment rate
Socio-demographic drivers
• Share of the population above 64 years
• Share of the population below 6 years
• Share of the foreign population
• Supply-side
Medical progress, proxied by the mortality rate
Physicians` density
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
6. 6
Federal Department of Finance FDF
Federal Finance Administration FFA
Determinants of public health care
expenditure
• Political-institutional determinants based on political
economics literature
Parliament size (common pool)
Composition of the pool of politicians in terms of gender
Institutional restrictions that aim at discipling politicians`
budgetary discretion (fiscal rules and mandatory referenda)
Election cycles and ideology
• Major Swiss healthcare reforms
Introduction of a mandatory healthcare insurance (1996)
Long-term care finance reform (2011) and hospital finance
reform (2012)
Use of global budgets.
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
7. 7
Federal Department of Finance FDF
Federal Finance Administration FFA
Results I
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
8. 8
Federal Department of Finance FDF
Federal Finance Administration FFA
Determinants of public health care
expenditure
• What determinants seem to be relevant to public healthcare
expenditure (expected sign & statistically significant)
• Real GDP per capita
• Unemployment rate
• Share of foreigners
• Share of women in parliament
• Population variables
• Difficult to disentangle from time fixed effects
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
9. Federal Department of Finance FDF
Federal Finance Administration FFA
How will public healthcare
expenditure be affected by population
ageing and non-demographic cost
drivers until 2060?
Long-term projections
10. 10
Federal Department of Finance FDF
Federal Finance Administration FFA
Methods and data
Scenarios are based on the following cost drivers
• Population ageing
• Relationship between the rising life expectancy and the health
status of the population
• Relationship between GDP and healthcare expenditure
• Healthcare as a luxury good (demand-side)
• Purchasing power increases with GDP => incentives for
medical innovations are increased (supply-side)
• Baumol‘s cost disease
• Scarcity of healthcare and long-term care personnel
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
11. 11
Federal Department of Finance FDF
Federal Finance Administration FFA
Results
Level 2009 2060 Change 2009-60
(in %)
Total healthcare 11.3 15.8 +4.5 40
Government (incl. social
welfare)
3.5 5.6 +2.1 60
Confederation 0-4 0.6 +0.1 50
Cantons 2.3 3.9 +1.7 70
Communes 0.3 0.6 +0.3 100
Old-age insurance helplessness
allowance (AHV-HE)
0.1 0.3 +0.2 200
Disability and old-age insurance
contributions (IV/ AHV-Beiträge)
0.3 0.2 -0.1 -33
Mandatory basic healthcare
insurance (OKP)
3.3 4.6 +1.3 39
Healthcare expenditure by source of financing
in reference scenario (in GDP % and in %)
12. 12
Federal Department of Finance FDF
Federal Finance Administration FFA
Results
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
Breakdown of public healthcare expenditure
by healthcare area in reference scenario (in %)
17
33
72
63
11
4
0%
20%
40%
60%
80%
100%
2009 2060
Long-term care from 65 Healthcare Long-term care below 65
13. 13
Federal Department of Finance FDF
Federal Finance Administration FFA
Implications for fiscal sustainability
Key results
• Importance of macroeconomic development.
• Some role for the composition of the pool of politicians.
• No role for institutional restrictions on budgetary
behavior.
• Consequences of recent reforms not clear.
• Ageing will become increasingly important
• Retirement of baby boomers
• Medical progress
• Crucial determinant of healthcare expenditure
• But difficult to measure
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
14. 14
Federal Department of Finance FDF
Federal Finance Administration FFA
Implications for fiscal sustainability
Evaluation of fiscal sustainability
• Cantonal budgets most severly affected by additional cost burden
• Cantonal share of public HCE in 2009: 66%; in 2060: 70%
• Public healthcare expenditure seriously affected by long-term care
from 65
• LTC-share in public HCE in 2009: 17%; in 2060: 33%
• Expenditure (in GDP %) of communes and old-age insurance
helplessness allowance double and triple resp. up to 2060
• Sustainabiliy of federal health budget not jeopardised as outlays
are practically limited to individual premium reduction
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015
15. 15
Federal Department of Finance FDF
Federal Finance Administration FFA
Implications for fiscal sustainability
Policy measures
• Monitoring: Regular analyses and projections on public
healthcare expenditure.
• Proposals for policy makers related to the Swiss
comprehensive health care strategy (Health 2020).
• Fostering preventive measures, e.g. improvement of
health education.
• Fostering organisational innovation, e.g. ehealth,
quality standards and coordinated care models.
• Prevention of shortage of skilled health labor force.
• Ensure adequate financing of long-term care (e.g., a
social insurance solution).
Public Healthcare Expenditure; Brändle/ Colombier;
OECD February 2015