Evaluación del espacio fiscal para salud en Bolivia

ABSTRACT Objective To assess from a technical and political point of view the capacity of Bolivia to generate fiscal space for health that allows it to sustain progress and fulfill the commitment of a public health expenditure of 6% of gross domestic product. Methods A review of the international ev...

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Bibliographic Details
Published in:Revista panamericana de salud pública 2018-09, Vol.42
Main Authors: Matus-López, Mauricio, Pozo, Desiderio Cansino, Pedraza, Camilo Cid, Romero, Werner Valdés
Format: Article
Language:eng ; por ; spa
Subjects:
Economic growth
Feasibility
GDP
Government spending
Gross Domestic Product
Health care expenditures
Informal economy
Investigación Original
Public health
Social research
Social security
Taxation
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Summary:ABSTRACT Objective To assess from a technical and political point of view the capacity of Bolivia to generate fiscal space for health that allows it to sustain progress and fulfill the commitment of a public health expenditure of 6% of gross domestic product. Methods A review of the international evidence on fiscal space and its measurements was conducted. The technical analysis was developed through statistics and official reports from multiple national and international secondary sources. The political and social analysis was carried out through 20 interviews with representatives of organizations and institutions. Results There is capacity to create fiscal space in health for Bolivia. There are three sources with the greatest technical and political feasibility: economic growth linked to the commitment to reprioritize public spending on health; improvements in the internal sources of revenue through the reduction of informal work; and reduction of tax expenditures. External financing and an increase of Social Security contributions are less feasible. Conclusions Bolivia is able to achieve a public health spending of 6% of gross domestic product. The timing to achieve this goal depends on maintaining the prioritization of spending in the sector, with social and political consensus and within a framework of economic growth and stability.
ISSN:1020-4989
1680-5348
DOI:10.26633/RPSP.2018.4