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Fifteen years later: moving forward Heller’s heritage on fiscal space for health

Economist Peter Heller, writing a seminal paper published in Health, Policy and Planning in 2006, identified five opportunities for expanding fiscal space for health: raising revenue, reprioritizing expenditure, borrowing, using seigniorage and mobilizing external grants. The development of the init...

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Autores principales: Barroy, Hélène, Gupta, Sanjeev
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428612/
https://www.ncbi.nlm.nih.gov/pubmed/33855368
http://dx.doi.org/10.1093/heapol/czab033
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author Barroy, Hélène
Gupta, Sanjeev
author_facet Barroy, Hélène
Gupta, Sanjeev
author_sort Barroy, Hélène
collection PubMed
description Economist Peter Heller, writing a seminal paper published in Health, Policy and Planning in 2006, identified five opportunities for expanding fiscal space for health: raising revenue, reprioritizing expenditure, borrowing, using seigniorage and mobilizing external grants. The development of the initial framework marked a significant conceptual advancement in health financing, by situating health reforms within a broader macro-fiscal context. Fifteen years later, fiscal space for health is not viewed simply as a question of finding additional revenues but also as a matter of improving public financial management (PFM) in the health sector, specifically for publicly funded health systems. This paper advances the concept of budgetary space for health, which explores available resources generated through greater overall public expenditure, prioritized budget allocations, and improved PFM. The paper adds a critical component, unpacking the ways through which PFM improvements can maximize budgetary space for health. The approach fits the realities of public finances in the era of the Sustainable Development Goals. The key implication is that PFM aspects should be systematically included in assessments of budgetary space to inform more effective country dialogues between the finance and health sectors.
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spelling pubmed-84286122021-09-10 Fifteen years later: moving forward Heller’s heritage on fiscal space for health Barroy, Hélène Gupta, Sanjeev Health Policy Plan Original Article Economist Peter Heller, writing a seminal paper published in Health, Policy and Planning in 2006, identified five opportunities for expanding fiscal space for health: raising revenue, reprioritizing expenditure, borrowing, using seigniorage and mobilizing external grants. The development of the initial framework marked a significant conceptual advancement in health financing, by situating health reforms within a broader macro-fiscal context. Fifteen years later, fiscal space for health is not viewed simply as a question of finding additional revenues but also as a matter of improving public financial management (PFM) in the health sector, specifically for publicly funded health systems. This paper advances the concept of budgetary space for health, which explores available resources generated through greater overall public expenditure, prioritized budget allocations, and improved PFM. The paper adds a critical component, unpacking the ways through which PFM improvements can maximize budgetary space for health. The approach fits the realities of public finances in the era of the Sustainable Development Goals. The key implication is that PFM aspects should be systematically included in assessments of budgetary space to inform more effective country dialogues between the finance and health sectors. Oxford University Press 2021-05-29 /pmc/articles/PMC8428612/ /pubmed/33855368 http://dx.doi.org/10.1093/heapol/czab033 Text en © The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Barroy, Hélène
Gupta, Sanjeev
Fifteen years later: moving forward Heller’s heritage on fiscal space for health
title Fifteen years later: moving forward Heller’s heritage on fiscal space for health
title_full Fifteen years later: moving forward Heller’s heritage on fiscal space for health
title_fullStr Fifteen years later: moving forward Heller’s heritage on fiscal space for health
title_full_unstemmed Fifteen years later: moving forward Heller’s heritage on fiscal space for health
title_short Fifteen years later: moving forward Heller’s heritage on fiscal space for health
title_sort fifteen years later: moving forward heller’s heritage on fiscal space for health
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428612/
https://www.ncbi.nlm.nih.gov/pubmed/33855368
http://dx.doi.org/10.1093/heapol/czab033
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