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[秘鲁公共卫生财政空间评估]

[An assessment of fiscal space for public health in Peru].

作者信息

Matus-López Mauricio, Toledo Lorena Prieto, Pedraza Camilo Cid

出版信息

Rev Panam Salud Publica. 2016 Aug;40(1):64-69.

Abstract

Objective To assess the fiscal space for public health in Peru so as to attain the goal of raising health spending to 6% of gross domestic product, as agreed upon by member countries of the Pan American Health Organization in 2014. Methods The main sources of fiscal space were identified by means of a thorough literature review. Technical feasibility was determined from statistics and national and international surveys and by reviewing various documents and official reports. Political feasibility was ascertained by studying policy guidelines. Results The sources showing the greatest technical and political feasibility are economic growth, a broadening of the personal income tax base, and an increase in tobacco-specific taxes. Decreasing informality in the job market and increasing contributory coverage are considered to be less politically feasible, but there is ample technical space for these measures. Conclusions There is enough fiscal space to allow for an increase in public health spending. Nevertheless, the 6% target will be reached only if the timeline is extended, tax revenues are increased, and informality in the job market is reduced.

摘要

目的 评估秘鲁公共卫生的财政空间,以实现泛美卫生组织成员国在2014年商定的将卫生支出提高到国内生产总值6%的目标。方法 通过全面的文献综述确定财政空间的主要来源。根据统计数据以及国家和国际调查,并通过审查各种文件和官方报告来确定技术可行性。通过研究政策指南确定政治可行性。结果 显示出最大技术和政治可行性的来源是经济增长、扩大个人所得税税基以及提高烟草专项税。减少就业市场的非正规性和增加缴费覆盖范围在政治上被认为可行性较低,但这些措施有充足的技术空间。结论 有足够的财政空间来增加公共卫生支出。然而,只有延长时间线、增加税收收入并减少就业市场的非正规性,才能实现6%的目标。

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