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Fiscal space for domestic funding of health and other social services

Published online by Cambridge University Press:  23 March 2017

Filip Meheus*
Affiliation:
Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Di McIntyre
Affiliation:
Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
*
*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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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.

Information

Type
Domestic financing
Creative Commons
Creative Common License - CCCreative Common License - BY
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.
Copyright
© Cambridge University Press 2017
Figure 0

Figure 1 Government revenue and expenditure as % of GDP by country category (2012) Source: International Monetary Fund (2014). Note: MENAP: Middle East, North Africa and Pakistan.

Figure 1

Figure 2 Relationship between log of per capita GDP and government expenditure (2012) Source: International Monetary Fund (2015).

Figure 2

Figure 3 Relationship between log of per capita GDP and government revenue (2012) Source: International Monetary Fund (2015).

Figure 3

Figure 4 Government gross debt as % of GDP by country category (2012) Source: International Monetary Fund (2014). Note: MENAP: Middle East, North Africa and Pakistan.

Figure 4

Figure 5 Distribution of government revenue in OECD countries by type of revenue (2011) Source: OECD (2013).

Figure 5

Figure 6 Distribution of tax revenue in OECD countries by type of tax (2012) Source: OECD (2014).