Table 11.4Lessons in Using Fiscal Policy for Health Promotion

Intervention choice Program design Instrument design Policy regime
  • Select interventions that directly address the health objective.
  • Ensure that interventions are sufficient to effect the health change, but not excessive.
  • Choose interventions with high health returns and low costs relative to alternatives.
  • Ensure that the health benefits of the desired change are apparent and significant.
  • Make sure that the tax base is adequate and stable and that no untaxed close substitutes are available.
  • Be aware that a large informal labor sector will limit the effectiveness and equity of benefit delivery.
  • Avoid programs whose expenses may become unsustainable because of uncontrollable factors.
  • Choose the appropriate recipients for a subsidy or tax preference.
  • Do not spread the benefits across too large a group.
  • Note that targeting by demographic, geographic, or need categories is more efficient than no targeting or self-targeting.
  • Be aware of the price elasticities of a taxed good so that its incidence is clear.
  • Ensure that policy is consistent and predictable.
  • Ensure that institutions carrying out a policy are open, accountable, and uncorrupted.
  • Consider tradeoffs between efficiency and distributional goals.
  • Seek non–health sector opportunities to effect health goals.

Source: Authors.

From: Chapter 11, Fiscal Policies for Health Promotion and Disease Prevention

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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