From Containment To Rationalization

Achieving France’s medium-term fiscal targets will require significant expenditure efforts. This paper identifies areas where there is scope for increasing expenditure efficiency, with a view to achieving higher quality and more sustainable fiscal consolidation. The methodology is based on a triple benchmarking. First, the level of public expenditure in different categories is compared to other European countries. Second, the impact of spending is assessed against other European countries. Third, the input mix is analyzed to understand what components are responsible for the level of spending and for the quality of outcomes This is done for various categories of spending and policies. Based on these results, the paper then provides policy options for expenditure reform in each of these areas, drawing on successful reform episodes in other countries.

The advent of consumer societies in the United Kingdom and West Germany after 1945 led to the mass 'production' of garbage. This book compares the social, cultural and economic fallout of the growing volume and changing composition of waste in the two countries from 1945 to the present through sustained attention to changes in the business of handling household waste. Though the UK and Germany are similar in population density, degrees of urbanisation, and standardisation, the two countries took profoundly different paths from low-waste to throwaway societies, and more recently, towards the goal of 'zero-waste'. The authors explore evolving balances between public and private provision in waste services; the transformation of public cleansing into waste management; the role of government legislation and regulation; emerging conceptualisations of recycling and resource recovery; and the gradual shift of the industry's regulatory and business context from local to national and then to international.

This publication contains a number of papers which consider the public health role of vaccines in improving the health of the world's populations, and looks at the challenges of using immunisation to combat emerging and re-emerging diseases. Issues discussed include the innovative use of vaccines against diseases such as meningococcal infection in Africa, Haemophilus influenza type b, varicella, and hepatitis, efforts to develop a new generation of vaccines against cholera and typhoid, shigella and Helicobacter pylori, as well as developments in the quest for vaccines against tuberculosis, HIV/AIDS, dengue, malaria, and hookworm. It also deals with the use of vaccines to fight bioterrorism attacks; regulatory and safety issues; financing issues, impact of health sector reform and the sustainability of immunisation programmes.

This 2016 Article IV Consultation highlights that economic recovery in France is solidifying. The economy is projected to expand by 1.5 percent in 2016, primarily driven by strong consumer spending. There are also signs of a cyclical recovery in investment, and the slump in residential construction appears to be bottoming out. By contrast, net exports are declining as demand from trading partners has slowed. Private sector job creation has remained lackluster, and the unemployment rate has hovered at about 10 percent. The government has continued to advance important reforms to help create the conditions for improved economic performance. As for budget policies, there are ongoing efforts to contain spending growth at all levels of government while easing taxes.

Belgium faces a fiscal consolidation challenge at a time when the fiscal cost of aging—primarily related to pension and health outlays—is mounting. Pension spending will increase relatively fast unless a combination of measures related to pension generosity and retirement eligibility are put in place. Potential efficiency gains are large in the health sector and could absorb part of the fiscal and reorganization costs related to an aging population.

Belgium: Selected Issues

Following the death of Franco, Spain underwent a transition to democracy in the mid-1970s. Although a rapid process of modernization occurred, the Spanish welfare state was seen, until fairly recently, as relatively underdeveloped. However, given the progressive Europeanization and expansion of Spanish social policy, questions arise as to whether the Spanish welfare system should still be considered as peripheral to West European welfare states. This volume is divided into three sections. The first section deals with broad trends in the evolution of the Spanish welfare state. To begin with, the consolidation path of social protection policies is explored. Attention is also paid to the process of Europeanization. Furthermore, the analysis explores advances in gender equality policies. In the second section, attention is turned to governance issues, such as collective bargaining, the interplay among levels of government, the welfare mix and public support for social policies. The third and final part of the book addresses five main challenges facing the Spanish welfare state in the 21st century, namely, the need to enhance flexicurity; to achieve a better work-family balance; to coordinate immigration policies with existing social protection; to tackle the persistence of high rates of relative poverty; and to face intense population ageing, both in terms of increasing needs for care and the reform of the pension system.

The proportion of people over 65 is substantially increasing and will continue to do so in the coming decades. Societies are concerned about the depletion of pension funds and austere fiscal plans that are unable to subsidize the basic care, protection and needs of their growing elderly populations. Gerontology is rapidly becoming a burgeoning research discipline that studies multiple aspects of human ageing, leading to top-down social policies that ineffectually address the significant needs of aged persons. Geriatric medicine has also expanded, attempting to medicalize the ageing process into a disease-free stage of “healthy ageing.” Ageing itself, this book argues, however, is not a disease per se, and should not be medicalized. In an era of uncertain medical expectations and unfulfilled social care of the ageing, this book presents an anthropological view, that focuses on three essential and transcendental conditions of human life that become vulnerable with advancing age: namely, relating to others, being in the world, and leaving a mark or legacy in the world.