Fiscal Space For Health In Latin America And The Caribbean

Countries that have made the most progress toward universal coverage have public expenditures in health equivalent to at least 6% of their gross domestic product (GDP), which is the percentage established in PAHO's universal health strategy as the benchmark for the countries. However, while higher expenditure is a prerequisite, it is not enough to combat inequities and advance toward universal health. In addition to greater resources, the quality of the expenditure must be improved, reducing health system inefficiencies. Moreover, public expenditure in health should be sustainably increased in a fiscally responsible manner. The concept of fiscal space for health refers to the ability of governments to provide additional budgetary resources for the health system without affecting the financial position of the public sector or supplanting other socially necessary expenditures. Any analysis of fiscal space, therefore, will attempt to identify the prospects for increasing health expenditure in the short and medium term to address a series of clearly established health needs. These efforts are under way at a critical time in the Region of the Americas, particularly in the countries of Latin America and the Caribbean, which are engaged in a singular health system reform process. For the first time in history, these countries have formalized their intention of increasing public expenditure in health, putting themselves firmly on the path to real and effective access to health care through the universal health strategy. Without achieving basic well-being at this level, it will be impossible to improve social cohesion and social development in the countries of the Region. This publication brings together and summarizes PAHO's studies on fiscal space for universal health in the Americas and draws on the contributions of the regional forum held in Washington, D.C. on 7-8 December 2015. With this publication, whose target audience is the technical personnel responsible for policy development, decision-makers, and authorities, PAHO hopes to contribute to the analysis and discussion of health financing policies on the path toward universal health.

How can this puzzle of larger demands and fiscal strengthening be solved? This edition of the development in the Americas (DIA) report focuses precisely on this question. The book suggests that the answer is about fiscal efficiency and smart spending rather than the standard solution of across-the-board spending cuts to achieve fiscal sustainability— sometimes at great cost for society. It is about doing more with less. · Analysis of government spending in Latin America and the Caribbean reveals widespread waste and inefficiencies that could be as large as 4.4 percent of the region’s GDP, showing there is ample room to improve basic services without necessarily spending more resources. · The publication argues against across-the-board cuts. It looks at whether countries spend too much or too little on different priorities, whether they invest enough to ensure a better future, and whether those expenditures make inequality better or worse. · Along with the diagnosis, the report offers several policy recommendations on how to improve the efficiency of government spending.

As the COVID†?19 crisis recedes, Latin America and the Caribbean (LAC) is back to work and looking forward. Reported deaths related to the pandemic are low and have plausibly converged to global levels. Yet low vaccination rates in some countries leave them vulnerable to new variants. In most countries, gross domestic product (GDP) and employment have fully recovered their 2019 levels, although forecasted growth rates might be said to be “resiliently mediocre†?: banking systems appear sound, and rising debt burdens are manageable so far, but growth is not expected to exceed the low levels of the 2010 decade. Poverty in terms of income (monetary poverty) has largely receded with the economic recovery, but the longer†?term scars of the pandemic in terms of education and health have planted deep seeds of future inequality. Redressing these problems and undertaking the structural reforms needed to reach higher levels of growth and reduce poverty remain central on the policy agenda. The new and unwelcome entrant in the policy space is inflation. While comparable to advanced country levels and well managed by regional monetary authorities, inflation nonetheless is being propelled by forces that may give it more staying power than originally hoped. Finally, public deficits induced by the pandemic and the need to finance critical government programs and directions have opened a fiscal gap and led to constrained fiscal space. The need to close the fiscal gap, put debt on a sustainable footing, and generate fiscal space to finance necessary physical and social investments has led to a search for new revenues and in particular to pressure to increase income taxes. In looking at any tax hike, concerns center on the possible depressive effects on growth, overall progressivity, and possible incentives for informality. This report presents new evidence on these effects for value added taxes (VAT) and income taxes. It also advocates for steps to cut wasteful government spending and increase government efficiency—both to generate substantial resources and as an entry point to a broader agenda of state modernization and generating public trust.

Fiscal Panorama of Latin America and the Caribbean, 2019 examines the role of tax policy as a tool for driving progress towards achievement of the Sustainable Development Goals. One way to strengthen collection is to address the challenges of taxing the rapidly growing digital economy. Tax policy can also be used to shift production and consumption patterns to encourage decarbonization of the economy and support improvements in public health. Lastly, the document analyses the constraints on domestic resource mobilization caused by fiscal incentives and how, effectively geared towards investment, these incentives could instead foster sustainable and inclusive development.

In 2021, Latin America and the Caribbean faces an economic and social context that will remain complex and uncertain. The coronavirus disease (COVID-19) pandemic continues to impact the region, with a fresh wave of cases that has led to the implementation of new public health measures to curb the spread of the virus. Vaccination campaigns, which are a priority, have been hampered by unequal access to vaccines globally and challenges in vaccine production and distribution. In this complex and uncertain context, the Fiscal Panorama of Latin America and the Caribbean, 2021 analyses the challenges for fiscal policy in the region as it continues to tackle the emergency and bring about a transformative post-pandemic recovery. Maintaining an expansionary fiscal policy will be key, and will require the support of international cooperation through development financing. The report also reflects on the need to promote tax policies that expand fiscal space, improve income distribution and maintain the sustainability of spending trajectories. Lastly, it examines progress in the mainstreaming of a gender perspective in fiscal policies in the region.

The Latin American Economic Outlook 2021: Working Together for a Better Recovery aims to analyse and provide policy recommendations for a strong, inclusive and environmentally sustainable recovery in the region. The report explores policy actions to improve social protection mechanisms and increase social inclusion, foster regional integration and strengthen industrial strategies, and rethink the social contract to restore trust and empower citizens at all stages of the policy‐making process.

This third edition of Government at a Glance Latin America and the Caribbean provides the latest available evidence on public administrations and their performance in the LAC region and compares it to OECD countries. This publication includes indicators on public finances and economics, public employment, centres of government, regulatory governance, open government data, public sector integrity, public procurement and for the first time core government results (e.g. trust, inequality reduction).

This publication examines the social impact of an unprecedented crisis.