Publication: Cyclical Patterns in Government Health Expenditures between 1995 and 2010 : Are Countries Graduating from the Procyclical Trap or Falling Back?
Loading...
Date
2014-04
ISSN
Published
2014-04
Author(s)
Editor(s)
Abstract
The 2008-09 global economic crises have shown that no country is immune to external challenges. When policy controls are missing or not used efficiently, crises can reverse progress even in advanced economies. This unexpected outcome has increased concerns about the ability of governments in developing countries to manage downturns. The question is whether current and future crises will reinforce the procyclical responses or whether these governments will be able to escape the procyclical trap. In the fiscal domain, countercyclical trends in developing countries are promising. Over the last decade, about a third of the developing world has been able to escape the procyclicality trap. Yet, little is known about the evidence on the cyclical patterns of government health spending. This descriptive analysis, which covers 183 countries between 1995 and 2010, provides empirical evidence on the cyclicality of government health expenditures, using panel data from a global macro database, the fiscal health database. The objective is to propose user-friendly diagnostic approaches in this area that can be easily replicated and updated to inform technical discussions and policy making.
Link to Data Set
Citation
“Velenyi, Edit V.; Smitz, Marc F.. 2014. Cyclical Patterns in Government Health Expenditures between 1995 and 2010 : Are Countries Graduating from the Procyclical Trap or Falling Back?. Health, Nutrition, and Population (HNP)
discussion paper;. © http://hdl.handle.net/10986/18643 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication The Jobs Crisis : Household and Government Responses to the Great Recession in Eastern Europe and Central Asia(World Bank, 2011-03-29)The financial crisis swiftly expanded into an economic crisis throughout America and Western Europe, from where it spread to developing countries that had depended on foreign direct investment, consumer and mortgage credit, trade, and remittances. By early 2009, it was clear that this economic downturn would be more severe than any crisis since the great depression, prompting some to it as the 'great recession.' Eastern European and Central Asian countries were hit particularly hard during 2009, global Gross Domestic Product (GDP) contracted for the first time since Second World War. The financial crisis and the ensuing economic downturn, the worst since the Great Depression in the 1930s, went hand in hand with tightening of credit markets, bank failures, firm closures, and high demand for social safety nets. This report, The jobs crisis: household and Government responses to the great recession in Eastern Europe and Central Asia, brings together evidence that World Bank teams have collected on the impact of the crisis on households and families in Eastern Europe and Central Asia. This report shows how the crisis was felt by Eastern European and Central Asian households. Not only did unemployment rise sharply but it also lasted longer. The report also shows that the pain of the recession was broader, with workers taking home smaller paychecks as firms offered lower wage rates and fewer hours of work to their workers. The jobs crisis finds that households used a variety of ways to cope with the crisis. The jobs crisis presents an account of how governments reacted to the crisis through social policy reforms and initiatives and how such responses could be improved in the future. Unemployment insurance benefits played a particularly important cushioning role, but coverage of the unemployed tended to be limited.Publication Fiscal Rules and the Pro-Cycylicality of Public Investment in the West African Economic and Monetary Union(World Bank, Washington, DC, 2013-08)Evidence from a large panel of low-income and lower middle-income countries over the period 1995–2012 suggests that, contrary to other countries, public investment in the West African Economic and Monetary Union (WAEMU) has been pro-cyclical. Public investment contracts more in “bad times” than it increases in “good times” and appears to have become pro-cyclical since the introduction of the fiscal convergence criteria in 1994. The pro-cyclicality of public expenditure and the high asymmetry of shocks that affect WAEMU countries justify exploring options for greater counter-cyclicality of rules-based fiscal frameworks and for risk-sharing.Publication Fiscal Adjustment and Growth in Sub-Saharan Africa : Overview and Lessons from the Current Downturn(2010-05-01)In light of the proliferation of exceptionally large fiscal stimuli to ward off the recession triggered by the 2008 global economic and financial crisis in most advanced economies, this paper revisits the fiscal adjustment and growth nexus in Sub-Saharan Africa. Using transfer functions, it quantifies expected losses in terms of aggregate output largely attributed to a systematic implementation of pro-cyclical expenditure switching and reducing policies to achieve low deficit targets throughout the decades of adjustments. The results consistently highlight a much higher predicted aggregate output under the hypothesized counter-cyclical fiscal expansion option. This consistent outcome suggests that the output gap would have been significantly smaller in the region if countries had drawn on stop-and-go policies of fiscal expansion to sustainably raise the stock of capital investments.Publication Towards 2015 : Spending for Indonesia's Development, Shaping the Prospects of a Middle-Income Country(Washington, DC, 2009-08)This report discusses the future of Indonesia's public expenditures as it enters the 21st century. It contributes to the discussion on Indonesia's spending priorities for the years ahead. These choices will impact the lives of Indonesians, and their opportunities to grow richer and receive better services. The report will contribute to Indonesia s next five-year plan, the RPJM, which will take effect in January 2010. Indonesia has been one of the most successful countries in reducing its debt-to-GDP ratio. Since 1999, when debt levels reached over 90 percent of GDP, Indonesia has reduced its debt levels to just above 30 percent of GDP by the end of 2008. Education spending increased from 11 percent of total government spending in 2001 to 15 percent in 2008. Chapter 1 discusses public spending from 2001 to 2009, including discretionary spending, key sectors, subsidies and decentralization. Chapter 2 analyzes Indonesia's economy in the current (2009) economic downturn. Indonesia is in a position of relative economic strength despite the impact of the global financial crisis. This is largely thanks to its broad-based growth that has avoided over-reliance on exports. The share of output that Indonesia exports is the smallest of the major Southeast Asian economies. Chapter 3 presents the future of Indonesia's fiscal growth to 2015. Notwithstanding noteworthy achievements over the past decade, Indonesia continues to face significant economic and social challenges, and major gaps remain in many areas of public expenditure. However, sustained fiscal consolidation and governance reforms, as well as resilience in the face of the global crisis, leave Indonesia well placed to push forward with sustained poverty reduction. Strategic use of public resources and continued growth could see swift improvement in economic and social outcomes over the coming five years.Publication Poland - Public Expenditure Review : Analysis of Social Sectors and Public Wages(World Bank, 2010-03-08)This report looks at public spending on pensions, education, health, social assistance, labor market programs, and public wages. Presenting the findings of a series of studies and notes compiled sice April 2009, it highlights how reforming such spending, which comprises about one quarter of gross domestic product (GDP), is essential for mitigating the impact of the economic crisis and for transforming Poland from a welfare state to a workfare society in line with Government's Vision 2030. The report has two main messages. First, Poland can take measures to reduce public expenditures on social sectors and public wages by around 2.3 percentage points over the next three years. Second, beyond supporting the fiscal adjustment required in the context of the economic crisis, public expenditure reforms can also help bring about structural changes envisioned as part of the Government's strategy for 2030. This report provides a comprehensive assessment of Poland's social sector and public wage polices and lays out options for reform. The summary report has five parts. The first part lays out the macroeconomic context. It emphasizes that Poland has weathered the global economic crisis remarkably well but that the recovery is likely to be feeble and subject to uncertainty. The next part discusses the fiscal fallout of the crisis and argues that public expenditure reform should be a crucial pillar for fiscal consolidation. Sections three to five contain the main findings of the report. Section three presents a list of important reforms of public expenditures on social sectors and wages in support of Vision 2030. Section four simulates the fiscal impact of public expenditure reforms, with a particular focus on state budget expenditures. The final section discusses how institutional reforms in the areas of medium-term and performance-based budget can support the reform agenda. Volume two presents the detailed analyses of social sectors and institutional reforms of public finance.
Users also downloaded
Showing related downloaded files
Publication Early Child Development, From Measurement to Action : A priority for Growth and Equity(Washington, DC: World Bank, 2007)The World Bank recently hosted a symposium on the priority of early child development (ECD) for economic growth and equity. The participants urged application of population-based tools and measures to assess the outcomes of children's early years and children's readiness for school. This study is derived from the symposium and is a valuable resource for policy makers, economists, donors, and investors, as well as researchers and practitioners in early child development. It summarizes the current neuroscience on early child development and major longitudinal studies, the rationale and urgency for greater investment, and countries' innovative funding strategies. The report consists of 15 chapters authored by ECD experts and leaders in the field. The chapters are grouped into five main parts relating to the: business imperative and societal benefits of ECD investments; lessons from evaluation of longitudinal ECD interventions; countries' experiences in monitoring ECD interventions; innovative approaches to countries' financing of ECD initiatives; and next steps on the ECD agenda for the next 5 years. A theme highlighted at the symposium and enlarged upon here is the urgent need for evidence- and population-based instruments and measures to monitor, evaluate, and compare ECD interventions over time and across settings.Publication Making Monitoring and Evaluation Systems Work : A Capacity Development Toolkit(World Bank, 2009)There are constant and growing pressures on governments and organizations around the world to be more responsive to demands from internal and external stakeholders for good governance, accountability and transparency, greater development effectiveness and delivery of tangible results. Governments, parliaments, citizens, the private sector, non-governmental organizations (NGOs), civil society, international organizations, and donors are all among stakeholders interested in better performance. As demands for greater accountability and results have grown, there is an accompanying need for useful and useable results-based monitoring and evaluation systems to support the management of policies, programs, and projects. Governments and other organizations have many different kinds of tracking systems as part of their management toolkits: good human resource systems, financial systems, and accountability systems. They also need good feedback systems. A results-based monitoring and evaluation (M&E) system is essentially such a feedback system; it is a management tool to measure and evaluate outcomes, providing information for governance and decision making. Many management systems have been missing a feedback component to enable them to track the consequences of actions. Building an M&E system gives decision-makers an additional management tool by providing feedback on performance as a basis for future improvement.Publication Climate Change and Migration : Evidence from the Middle East and North Africa(Washington, DC: World Bank, 2014-07-15)Climate change is a major source of concern in the Middle East and North Africa (MENA) region, and migration is often understood as one of several strategies used by households to respond to changes in climate and environmental conditions, including extreme weather events. This study focuses on the link between climate change and migration. Most micro-level studies measure climate change either by the incidences of extreme weather events or by variation in temperature or rainfall. A few studies have found that formal and informal institutions as well as policies also affect migration. Institutions that make government more responsive to households (for example through public spending) discourage both international and domestic migration in the aftermath of extreme weather events. Migration is often an option of last resort after vulnerable rural populations attempting to cope with new and challenging circumstances have exhausted other options such as eating less, selling assets, or removing children from school. This study is based in large part on new data collected in 2011 in Algeria, Egypt, Morocco, Syria, and the Republic of Yemen. The surveys were administered by in-country partners to a randomly selected set of 800 households per country. It is also important to emphasize that neither the household survey results nor the findings from the qualitative focus groups are meant to be representative of the five countries in which the work was carried, since only a few areas were surveyed in each country. This report is organized as follows: section one gives synthesis. Section two discusses household perceptions about climate change and extreme weather events. Section three focuses on migration as a coping mechanisms and income diversification strategy. Section four examines other coping and adaptation strategies. Section five discusses perceptions about government and community programs.Publication Changing the Face of the Waters : The Promise and Challenge of Sustainable Aquaculture(Washington, DC: World Bank, 2007)This study provides strategic orientations and recommendations for Bank client countries and suggests approaches for the Bank's role in a rapidly changing industry with high economic potential. It identifies priorities and options for policy adjustments, catalytic investments, and entry points for the Bank and other investors to foster environmentally friendly, wealth-creating, and sustainable aquaculture. The objectives of the study are to inform and provide guidance on sustainable aquaculture to decision makers in the international development community and in client countries of international finance institutions. The study focuses on several critical issues and challenges: 1) Harnessing the contribution of aquaculture to economic development, including poverty alleviation and wealth creation, to employment and to food security and trade, particularly for least developed countries (LDCs); 2) Building environmentally sustainable aquaculture, including the role of aquaculture in the broader suite of environmental management measures; 3) Creating the enabling conditions for sustainable aquaculture, including the governance, policy, and regulatory frameworks, and identifying the roles of the public and private sectors; and 4) Developing and transferring human and institutional capacity in governance, technologies, and business models with special reference to the application of lessons from Asia to Sub-Saharan Africa and Latin America.Publication Disease Control Priorities, Third Edition(Washington, DC: World Bank, 2016-04-06)This book focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. It also includes the transition to older childhood, in particular, the overlap and commonality with the child development volume.