FISCAL POLICIES FOR POPULATION HEALTH
The process of moving towards universal health coverage is likely to run up against two important hurdles. Firstly, the economic slowdown has significantly reduced growth rates and by extension government revenues. Government expenditure has been tightened, as has fiscal spending on health.
A further challenge is the weakness and therefore the inability of the public healthcare system to deliver the quality of coverage that would encourage people to seek care. In this context there is great interest in fiscal measures, including taxes, subsidies, and tariffs that can improve health without reliance on additional budgetary allocations. When it is recognised that health is predominantly determined from outside the health sector there are many policies that could be considered. Fiscal policies might be a useful alternative to regulation, particularly in areas where regulation is challenged by influential agents.
Supported by a grant to PRICELESS SA from the Bill & Melinda Gates Foundation through the Center for Disease Dynamics, Economics & Policy (CDDEP, Washington) and the Public Health Foundation of India (PHFI), an Expert Panel on Fiscal Policies for Health has been established.
This panel and its associated secretariat at PRICELESS is in the process of identifying and evaluating taxation, tariff, and subsidy policy changes that have the greatest potential to improve health. Similar evidence is being generated by counterparts in India where a parallel process is underway. Chairs of this panel are Kate O’Regan (a former Constitutional Court judge) and Prof. Leila Patel. The panel is constituted with South African experts from the fields of finance, transportation, nutrition, education, political science and other areas where consideration of health consequences could potentially support and enhance universal health coverage.