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OECD experience on fiscal sustainability

OECD experience on fiscal sustainability. Joint OECD/WHO Meeting on Financial Sustainability of Health Systems Edwin Lau Deputy Head, Budgeting & Public Expenditures Division, OECD 28 June 2012. Health is 2 nd largest public expenditure area in OECD.

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OECD experience on fiscal sustainability

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  1. OECD experience on fiscal sustainability Joint OECD/WHO Meeting on Financial Sustainability of HealthSystems Edwin Lau Deputy Head, Budgeting & Public Expenditures Division, OECD 28 June 2012

  2. Health is 2nd largest public expenditure area in OECD

  3. And healthexpenditures are rising Annual average growth in real per capita expenditure on health and GDP, 2000-2009 (or nearest year) • New challenges: • Ageing populations : ex. Koreanpopulation aged over 65 yearswillrepresent 37% of total Korean population in 2050 • Uptake of new technology : more costly and requires more skills and training • Increase in multi-morbidity : continuingcare, complications & acute care have considerablebearingon healthspending

  4. Is healthcrowding out otherexpenditure areas?

  5. Health measures frequently proposed in fiscal consolidation plans

  6. And proposed reductions are significant

  7. Short-term cuts ≠ effectiveness or fiscal sustainability • Achieving all of these goals: • Delivering healthcare efficiently • Maximizing health outcomes • Increasing the distribution of health (equity) • Maintaining fiscal stability OBJECTIVES • Requires these challenges to be tackled: • Both technical & allocative efficiency • Maximizing outcomes for a given level of inputs (programmeeffectiveness ) • A financing system that reflects society’s consensus on risk pooling & cross subsidies • A revenue stream that is both stable (broad-based) and predictable (counter-cyclical, stability for planning & pricing) • Fiscal sustainability (willingness to pay for a level of demand) CHALLENGES

  8. Purpose of SBO HealthSustainability Network • Financial situation calls on for new forms of co-operationto achievefiscal sustainability, but also value for money, and access and equality of health care. • Main objectives: • Establishinstitutional dialogue, clarity of roles, and common objectives and vocabulary • Find and disseminateappropriate good practice • Bettershareexistingwork (analysis and data) • Assist countries movingtowardsuniversalaccess to healthinsurance • OECD organised a first meeting in Nov 2011: • SuccessfullybroughttogetherHealth Budget officialsfromMinistries of Health and Ministries of Finance, as well as Social Security Institutions/HealthInsuranceFunds • Stronginterest by both countries and other international organisations (WHO, World Bank andADB)

  9. Balancing demand for care with ability to pay Sessions 3&4 • Design of health financing system Session 6 • Setting healthcareexpenditurelevels • Estimating future & current health spending needs • Co-ordination function Session 6 • Expenditure management • RevenueGeneration Sessions 5 Sessions 3&4

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