An assessment of fiscal space for health in Peru

Abstract

Suggested citation (original article) Matus-López M, Prieto Toledo L, Cid Pedraza C. Evaluación del espacio fiscal para la salud en Perú. Rev Panam Salud Publica. 2016;40(1):64-69. ABSTRACTObjective. To assess the fiscal space for health in Peru needed to attain the target of raising public spending in health to 6% of gross domestic product, as agreed by member countries of the Pan American Health Organization in 2014.Methods. The main sources of fiscal space were identified by means of a thorough literature review. Technical feasibility was determined from statistics and national and international surveys and by reviewing various documents and official reports. Political feasibility was ascertained by studying policy guidelines.Results. The sources showing the greatest technical and political feasibility are economic growth, a broadening of the personal income tax base, and an increase in tobacco-specific taxes. Decreasing informality in the job market and increasing contributory coverage are considered to be less politically feasible, but there is ample technical space for these measures.Conclusions. There is enough fiscal space to allow for an increase in public spending in health. Nevertheless, the 6% target will be reached only if the timeline is extended, tax revenues are increased, and informality in the job market is reduced.

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“…Peru is the country with the 18th most cases worldwide, and it is also the country with the highest case-fatality rate (9.4%) [ 2 , 3 ]. Additionally, the impact of the pandemic has been particularly intense in Peru, since it is a developing country, with a medium response capacity to pandemics, limited access to basic services, high rates of poverty and job insecurity, and public spending on health accounting for 4.2% of the gross domestic product (GDP) in 2020, a value below WHO recommendations (6.0% of GDP) [ 4 ]; these factors mainly affect disadvantaged populations in Peru [ 5 , 6 ].…”

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“…Kanavos 54 showed that Peru has sufficient fiscal space to increase taxes earmarked for health. Matus-Lopes et al 55 showed the potential for a broadening personal income tax base. Kanavos and Matus-Lopes agree that the 6% target for public health expenditure can only be reached long term while addressing the informality issue of the Peruvian economy.…”

Service Management Model Based on Lean and Kaizen Tools to Improve the Level of Satisfaction in Health Sector Companies

“…Thehealth sector belongs to the tertiary sector, which expanded, reaching over 60% of gross domestic product (GDP) since 2015, generating a relevant impact on economic growth in Peru [1]. Additionally, health spending in Peru reaches 5.3% of GDP, of which 58.7% belongs to public health spending and 41.2% to private expenditures [2]. On the other hand, the service sector accounts for 42.3% of the country's employed population, equivalent to more than 7 million jobs [3].Furthermore, user satisfaction is an indicator of the quality of care provided in health services.…”