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Accrual Budgeting: Think Carefully Before Jumping

[Warning: this is a technical blogpiece for public financial management specialists] Is moving to a accrual budgeting a good idea? This is a question I am asked from time to time. It is a controversial matter which needs to be carefully considered by any country contemplating making this move. Accrual budgeting has benefits, but also […]

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Health Care: What’s at Stake in the Presidential Election

Of all of the issues facing Americans in next Tuesday’s presidential election, healthcare is one of the biggest. Healthcare is a huge financial burden on Americans. The bad news is that the burden is set to become even heavier in coming years. This is why bold reforms are needed to tackle the waste and profiteering […]

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Long-Term Care Spending Will Grow Greatly

Although it is not the main driver of rising health expenditure, population aging will be a significant source of pressure on government budgets in other areas. Age pensions will, in some countries, be part of the problem. In the United States, for example, Congressional Budget Office projections suggest that government age pension spending will rise […]

Population Aging & Health Spending

There is a widespread notion that demographic aging will be the most important single factor driving health expenditure up over coming decades – or that, at a minimum, its impact on spending will be as great as any of the other forces which may be at work to increase spending. This is, however, wrong. Why […]

Bioscience Revolution To Drive Health Spending Up

In Bigger Government: The Future of Government Expenditure in Advanced Economies I show that government spending is set to increase greatly over the coming three decades in all advanced countries because of powerful external forces and pressures which will operate irrespective of the political orientations of governments. Overshadowing everything else will be very large long-term […]