Despite the increasing interest in universal health care, little is known about the optimal way to finance, design, and implement it. This paper attempts to fill this gap by providing some general policy recommendations on this important issue. While most of the paper addresses the Eastern Caribbean Currency Union (ECCU) countries, its policy implications are applicable to any country. The paper finds that the best financing option is country-specific depending on a country’s economic, cultural, institutional, demographic and epidemiological characteristics, as well as political economy considerations. However, taxation should be the primary financing source. It also concludes that an appropriate and realistic benefit package would need to be designed to ensure the system’s financial viability. Regarding the optimal way to implement universal health care, certain preconditions are needed, including sound public administration, a small informal economy, and a transparent health financing system that builds social consensus.
This Selected Issues paper analyzes the competitive threats to the tourism sector in the Eastern Caribbean Currency Union (ECCU). The paper concludes that the ECCU countries have lost competitiveness globally and vis-à-vis newly emergent Caribbean tourist destinations as a result of both price and nonprice factors. The short-term measures implemented by the countries seem to have been insufficient to prevent further declines in 2002. The paper also describes strengthening fiscal discipline through fiscal benchmarks.