Fiscal space for sustainable financing of health systems and universal health

Pedraza et al.

Original article in Spanish published 27 December 2018

The articles published in this series show that it is possible to create fiscal space for health in countries. This requires specific decisions since economic growth is not enough to generate the additional resources needed. The studies analyze the benefits of reviewing tax expenditures to identify exemptions, which are generally outdated and of low benefit for the countries; arguments in favor of increasing taxes on products harmful to health; and credits and donations, which do not result in a viable source of income for governments. Fiscal efforts must be accompanied by an improvement in efficiency, and the progressive creation of new revenues is key to improving equity. It is necessary to improve the collection of fiscal resources. It is necessary to develop a research and action agenda that includes the analysis of fiscal space within the processes of health system transformation and reform, including technical aspects not yet addressed and studies of the social efficiency of fiscal space for major development objectives such as the Sustainable Development Goals 2030. In the countries of the Region of the Americas it is essential to have efficient management to do more and better with more resources, even during adverse economic cycles. This should be evident at all levels, including solidarity for achieving better health outcomes, the strategic purchase of goods and services for health, and the strengthening of budget planning systems.

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