The notion that performance budgeting means budgeting based on outcomes is surprisingly widespread. It is, however, a misconception – a misconception which has led to confusion and missteps in PFM reform in some countries, particularly in the developing world. Outcome-based budgeting refers to the idea that governments should budget by deciding the outcomes they wish […]
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 […]
Is Austerity to Blame?
In many advanced countries, the parlous condition of public hospitals – due largely to inadequate funding – has been thrown into sharp relief by the coronavirus crisis. The United States, France and the United Kingdom are extreme examples. In these and other countries, many public hospitals were grossly stressed even before the pandemic, with patients […]