Marijn Verhoeven, Mr. Sanjeev Gupta, and Mr. Erwin H Tiongson
This paper estimates the impact of public spending on the poor's health status in over 70 countries. It provides evidence that the poor have significantly worse health status than the rich and that they are more favorably affected by public spending on health care. An important new result is that the relationship between public spending and the health status of the poor is stronger in low-income countries than in higher-income countries. However, the results suggest that increased public spending alone will not be sufficient to meet international commitments for improvements in health status.
The paper assesses the government expenditure effects from changing demographics in the Asian “Tiger” economies through 2050. With some exceptions, their limited social insurance commitments initially suggest that aging populations may not adversely affect fiscal balances. Yet for all the Tigers, changing illness patterns and medical modernization may combine with demographics to intensify budgetary pressures. The paper notes the implications of the Tigers’ reliance on private sector pension and medical insurance systems; the need for an active public role; and the complications for fiscal analysis when private sector instruments are used, in a mandatory way, as public policy instruments.