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Fiscal space for domestic funding of health and other social services

  • Filip Meheus (a1) and Di McIntyre (a1)
Abstract
Abstract

To progress toward universal health coverage and promote inclusive social and economic development, it will be necessary to strengthen domestic resource mobilization for health. In this paper, we examine options for increasing domestic government revenue in low- and middle-income countries. We analyze the relationship between level of economic development and levels of government revenue and expenditure, and show that a country’s level of economic development does not predetermine its spending levels. Government revenue can be increased through improved tax compliance and efficiency in revenue collection, maximizing revenue from mineral and other natural resources, and increasing tax rates where appropriate. The emphasis should be on increasing revenue through the most progressive means possible; the purpose of raising government spending on health would be defeated if that spending were funded by increasing the relative tax burden of those who are meant to benefit. Increasing government revenue through taxation or other sources is first and foremost a fiscal policy choice or political decision and should be supported through concerted global action.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
*Correspondence to: Dr Filip Meheus, International Agency for Research on Cancer, World Health Organisation, 150 Cours Albert Thomas, 69372 Lyon, France. Email: meheusf@iarc.fr
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Present address: International Agency for Research on Cancer, World Health Organisation, 150 Cours Albert Thomas, 69372 Lyon, France.
Present address: Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, South Africa.
Footnotes
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

D. M. Fox (2004), ‘The administration of the Marshall Plan and British Health Policy’, The Journal of Policy History, 16(3): 191211.

J. Kutzin (2012), ‘Anything goes on the path to universal coverage?’, Bulletin of the World Health Organization, 90(11): 867868.

D. McIntyre , F. Meheus and J-A. Røttingen (2017), ‘What level of domestic government health expenditure should we aspire to for universal health coverage?’, Health Economics, Policy and Law, 12(2): 125137.

A. Mills , J. E. Ataguba , J. Akazili , J. Borghi , B. Garshong , S. Makawia , G. Mtei , B. Harris , J. Macha , F. Meheus and D. McIntyre (2012), ‘Equity in financing and use of health care in Ghana, South Africa and Tanzania: implications for paths to universal coverage’, Lancet, 380(9837): 126133.

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Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
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